重组人粒-巨噬细胞集落刺激因子治疗放射性食管炎的疗效

目的 探讨重组人粒-巨噬细胞集落刺激因子(rhGM-CSF)对放射性食管炎的疗效.方法 对31例出现3级放射性食管炎的患者口服5ml注射用水 300μg rhGM-CSF 75%甘油20ml的混合液分4次,每间隔1小时用药1次,连用5d.结果 31例中,放射性食管炎自3级退回至0～1级者13例(41.94%),退至2级者15例(48.39%),继续维持在3级者3例(9.68%),总有效率为90.32%.结论 rhGM-CSF对放射性食管炎具有明显的治疗作用.     

食管癌分次放疗期间靶区不确定性初步研究

Objective To investigate the changes of target during fractionated radiotherapy for e-sophageal cancer, and to assess their impact on the implementation of radiotherapy. Methods Fourteen pa-tients with unresectable esophageal cancer were enrolled to receive full course conformal radiotherapy. CT scans were performed after every ten fractions. New targets (GTV) were delineated on repeated CT scans. Then the pretreatment radiotherapy plans were copied to the new targets to investigate the conformity between the new GTV and the plans. Results The majority of the GTVs decreased with the increasing fractions dur-ing radiotherapy. However, GTVs of 35.7% (5/14) patients increased by 2.0%-37.7% at the tenth frac-tion. The PTVs covered by 95% isodose curve at the time of pretreatment,tenth fraction,twentieth fraction and thirtieth fraction were 97.81%±1.53%, 91.95%±5.25%, 94.27%±4.23% and 94.03%±6.45%, respectively. Moreover, at tenth, twentieth and thirtieth fraction, there were 6,5, and 4 patients whose PTVs covered by 95% isodose curve were below 95%, respectively. Conclusions There are signifi-cant target changes during fractionated radiotherapy for esophageal cancer, which may result in uncertainties of radiotherapy implementation.     

Ⅰ、Ⅱ期舌癌的间质放疗结果:最大肿瘤深度预示区域淋巴结转移

在早期舌癌的治疗中,放射治疗与外科手术治疗的局部控制率相同,而放射治疗能保持原有器官功能,具有明显的优越性。另一方面,邻近区域淋巴结转移仍是早期舌癌治疗失败的主要原因。早期发现和治疗颈部区域淋巴结转移对预后至关重要。近来有作者报道,肿瘤最大浸润深度(MTT)与区域淋巴结转移明显相关,但目前仍未有一个统一的MTT     

三维适形放疗联合卡培他滨治疗局部晚期（不可手术）直肠癌

目的观察三维适形放疗同期口服卡培他滨治疗局部晚期（不可手术）直肠癌患者的近期疗效及治疗的依从性。方法38例经病理证实的局部晚期（T4或局部-区域复发）的直肠癌患者接受了全盆腔三维适形放疗（3DCRT）,DT46～50Gy/23～25F,后缩野至肿瘤区继续推量至DT64～66Gy/32～33F,同期接受卡培他滨（1650mg.m-2.d-1）治疗,分2次口服,第1～14天,每3周为1个周期,共服用2个周期。结果疗效评价：CR5例（13.2%）,PR17例（44.7%）,SD10例（26.3%）,PD6例（15.8%）,总有效率（CR＋PR）57.9%;中位生存时间18.0个月,1年和2年总生存率分别为63.43%和18.78%。疼痛症状缓解率为100%;全身状况好转率52.8%。治疗相关的毒副反应以腹泻、中性粒细胞减少及手足综合征为主,其Ⅲ级反应的发生率分别为15.8%、15.8%和7.9%,均无Ⅲ级以上反应。结论3DCRT联合口服单药卡培他滨的同期放化疗方案是局部晚期（不可手术）直肠癌较好的治疗方法,其治疗的依从性高、毒副反应轻、近期疗效肯定、姑息性减症作用明显,值得临床推广应用。     

局部晚期直肠癌患者同期放化疗的护理

目的 通过对局部晚期直肠癌患者在同期放化疗期间实施全方位的护理,达到提高患者的治疗耐受性,使其能顺利按计划完成治疗方案.方法 对25例局部晚期直肠癌患者,在接受同期放化疗期间,实施全方位的心理护理、静脉炎的预防护理、消化道反应的护理、骨髓抑制的护理、神经毒性反应的护理、照射野皮肤的护理及人工肛门的护理.结果 局部晚期直肠癌患者同期放化疗后出现不同程度的毒副反应,其中照射野皮肤反应25例;消化道反应25例;骨髓抑制20例;神经毒性反应7例;静脉炎反应2例.25例患者均能按计划完成治疗方案.结论 同期放化疗期间通过积极的对症治疗,加强护理措施,将患者的不适降到最低,提高了患者的生存质量.     

局部晚期口腔及口咽部癌的手术前联合化、放疗

60年代以来,一些研究表明,对于局部晚期头颈部肿瘤患者采用化疗(特别是含有顺铂和5-FU的方案)和放疗相联合与单纯的放疗相比,肿瘤的反应性有明显增高。作者为此对不能手术的局部晚期患者进行了术前联合应用化、放疗的Ⅱ期临床试验。40例患者均为临床Ⅲ-Ⅳ期的口腔或口咽部鳞     

高等医学院校肿瘤学教学调查与分析

目前 ,恶性肿瘤在我国各种死因中居第二位 ,在部分城市已排在首位 ,特别是从２０世纪７０年代到９０年代 ,肿瘤死亡率呈明显上升趋势 ,由每年８３ ６５／１０万上升至１０８ ２６／１０万 ,是发达国家的几倍甚至十倍以上〔１〕。恶性肿瘤在我国已成为一种多发病、常见病的现实 ,使得我国需要越来越多的、合格的医务工作者参与到临床肿瘤学事业中来。而我国各医院的临床医生主要来源于高等医学院校五年制本科教育中临床医学专业所培养的毕业生 ,很显然 ,各医学院校临床医学专业教学质量的高低将显著影响我国临床肿瘤学工作的质量。为了了解目…     

食管癌分次放疗期间靶区不确定性初步研究

Objective To investigate the changes of target during fractionated radiotherapy for e-sophageal cancer, and to assess their impact on the implementation of radiotherapy. Methods Fourteen pa-tients with unresectable esophageal cancer were enrolled to receive full course conformal radiotherapy. CT scans were performed after every ten fractions. New targets (GTV) were delineated on repeated CT scans. Then the pretreatment radiotherapy plans were copied to the new targets to investigate the conformity between the new GTV and the plans. Results The majority of the GTVs decreased with the increasing fractions dur-ing radiotherapy. However, GTVs of 35.7% (5/14) patients increased by 2.0%-37.7% at the tenth frac-tion. The PTVs covered by 95% isodose curve at the time of pretreatment,tenth fraction,twentieth fraction and thirtieth fraction were 97.81%±1.53%, 91.95%±5.25%, 94.27%±4.23% and 94.03%±6.45%, respectively. Moreover, at tenth, twentieth and thirtieth fraction, there were 6,5, and 4 patients whose PTVs covered by 95% isodose curve were below 95%, respectively. Conclusions There are signifi-cant target changes during fractionated radiotherapy for esophageal cancer, which may result in uncertainties of radiotherapy implementation.     

全脑全脊髓放疗的血液学毒性

血细胞生长因子(HGFs)和干细胞移植已用于对抗大剂量化疗后的骨髓毒性作用,同样的方法建议用于放疗,尤其是包括大量活跃骨髓的放疗,如全脑全脊髓(CSA)照射。但病人的选择显得非常重要。为此,作者回顾性分析了1965～1994年间Royal Marsden医院收治的210例中枢神经系统肿瘤患者的资料。所有病人都接受了兆伏X线CSA照射。全脑照射30～40Gy,原发灶平均剂量55Gy,脊髓剂量是30Gy,转移灶再加量5～10Gy。平均治疗时间为8