Efficacy and feasibility of gemcitabine and carboplatin as first-line chemotherapy in elderly patients with advanced non-small cell lung cancer

Background Although platinum-based chemotherapy is a standard first-line treatment in advanced non-small cell lung cancer （NSCLC）, further research for the safety and efficacy of combination chemotherapy in elderly patients has been required. The purpose of this study was to evaluate the efficacy and safety of gemcitabine and carboplatin as first-line treatment in elderly patients with advanced NSCLC and to evaluate the prognostic factors. Methods Eligibility included： （1） age of 70 years or more, （2） histologically confirmed NSCLC, （3） chemotherapy-na＇l＇ve, （4） advanced disease with stage IIIB or IV, （5） Eastern Cooperative Oncology Group （ECOG） performance status （PS） 0-2, （6） adequate organ function. Patients received intravenous carboplatin （area under curve （AUC）=5） on day 1 and gemcitabine （1000 mg/m2） on days 1 and 8, every 3 weeks. Results The medical records of forty patients were reviewed retrospectively. Median age was 73.9 years （range, 70- 84.6）, and there were 27 men （67.5%）. Thirty-seven patients （92.5%） had ECOG PS 0-1. Adenocarcinoma was found in 57.5%. Median cycles were administrated with 4.5 per person （range： 1-6）. Best responses were partial response in 22 （55.0%） patients and stable disease （SD）in 13 （32.5%）. The median progression free survival （PFS） and overall survival （OS） were 5.9 months （95% CI： 4.5-7.3 months） and 9.6 months （95% CI： 8.2-11.0 months）, respectively. Grade 4 hematologic toxicities for neutropenia （7.5%）, thrombocytopenia （7.5%） and anemia （5.0%） were observed. Histology was significant prognostic factor for PFS （P=0.024）. Conclusion Gemcitabine and carboplatin combination chemotherapy is an effective and manageable treatment option in elderly advanced NSCLC patients with good performance status.     

A phase II trial of oxaliplatin plus S-1 as a first-line chemotherapy for patients with advanced gastric cancer

Background Palliative chemotherapy has been shown to have a survival benefit for patients with recurrent or metastatic gastric cancer. We conducted a Phase II trial to determine the efficacy and safety of S-1 plus oxaliplatin （SOX regimen） as first-line chemotherapy for patients with unresectable locally advanced or metastatic gastric cancer. Methods Eligible patients had measurable lesions and no previous history of chemotherapy （except adjuvant chemotherapy）. Oxaliplatin was administered intravenously at a dose of 130 mg/m2 on day 1. S-1 was administered orally in doses of 80, 100, or 120 mg/d according to body surface areas of 〈1.25 m2, 1.25-1.5 m2, or 〉1.5 m2 respectively; the total dose was divided into two daily doses on days 1-14. Treatments were repeated every 3 weeks until disease progression or intolerable toxicity occurred. Results Forty-three patients were enrolled in the study. All were assessable for efficacy and adverse events. The objective response and disease control rates were 55.8% and 76.7% respectively. The median follow-up time was 16.5 months. The median progression-free survival time was 7 months （95% CI, 5.8-8.2 months） and the median overall survival time was 16.5 months （95% CI, 9.7-23.3 months）. The one-year survival rate was 54.2%. Major adverse reactions were grade 3/4 neutropenia （9.3%） and thrombocytopenia （20.9%）. Conclusion The SOX regimen with oxaliplatin at a dose of 130 mg/m2 was found to be effective and safe as a first-line chemotherapy in Chinese patients with advanced gastric cancer.     

Efficacy of radical cystectomy plus adjuvant intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced bladder cancer

Background Bladder cancer is the ninth most common cancer in the world; fewer than 15％ of transitional-cell carcinoma patients survive 2 years if left untreated.Although radical cystectomy is the standard treatment of choice,much of them relapse and the necessity of adjuvant chemotherapy is still under debate.The aim of the study was to evaluate the efficacy of adjuvant intraarterial chemotherapy （IAC） with gemcitabine and cisplatin （GC） on locally advanced bladder cancer.Methods This is a retrospective study on 60 patients with locally advanced bladder carcinoma who underwent radical cystectomy between May 2000 and June 2011.Patients were studied in two groups based on IAC and followed up for up to 5 years.Results Among 60 patients,there were 25 patients who underwent IAC （GC） after radical cystectomy （the IAC group） and 35 patients who underwent radical cystectomy alone （the control group）.Although not significant,the relapse rates were slightly reduced in the IAC group than in the control group.Patients with IAC had a reduction in mortality compared with patients without IAC over 5 years.Specifically,IAC significantly reduced about 82％ of mortality within the first year （hazard ratio=0.18,95％ Cl 0.03-0.97,P=-0.04）.Additionally,IAC was well tolerated and safe.The most common adverse effect was transient myelosuppression （10/25,40％）,which was resolved by various medical treatments.Conclusions Compared with radical cystectomy alone,radical cystectomy in combination with adjuvant IAC moderately but significantly reduces 1-year mortality.Our preliminary data showed only marginal benefit for the early survival.However,a randomized clinical study is needed to determine the long-term survival benefit.     

Effect of Neoadjuvant Chemotherapy Treatment on Prognosis of Patients with Advanced Gastric Cancer:a Retrospective Study

Objective To evaluate the prognostic effects of neoadjuvant chemotherapy (NAC) in patients with local advanced gastric cancer.
Methods We retrospectively analyzed prognosis in 191 patients with advanced gastric cancer, of whom 71 were treated with NAC and 120 received surgery only between February 2007 and July 2013. Postoperative complication rate was recorded. Survival by clinicopathological features, pathological T and N stages, and histopathological tumor regression was retrospectively compared between the two groups.
Results According to Response Evaluation Criteria in Solid Tumors, none of the 71 patients in the NAC followed by surgery group showed complete response, 36 showed partial response, 25 had stable disease, and 10 had progressive disease. The chemotherapy response rate was 50.7%;the disease control rate was 85.9%. Grade 3/4 adverse events were seen in less than 20% patients, with acceptable toxicities. No difference was found in the overall postoperative complication rates between the two groups (7 versus 22 cases, P=0.18). Median survival time was significantly different, at 54 months in the NAC combined with surgery group and 25 months in the surgery-only group (P=0.025).
Conclusion In patients with operable gastric adenocarcinomas, NAC can significantly improve overall survival without increasing surgical complications.     

Chemotherapy with or without irinotecan in patients with advanced or recurrent gastric cancer: a meta-analysis of randomized controlled trials

Background Studies have shown that irinotecan can improve survival in patients with advanced or recurrent gastric cancer,but the overall benefit of irinotecan in the treatment of advanced or recurrent gastric cancer remains controversial.The aim of this study was to evaluate the benefits and risks of irinotecan for survival in patients with advanced or recurrent gastric cancer.Method We searched PubMed,EmBase,the Cochrane Central Register of Controlled Trials,reference lists of articles,and proceedings of major conferences for relevant clinical trials.We included randomized controlled trials that reported on the efficacy and safety of irinotecan in patients with advanced or recurrent gastric cancer.Outcomes were analyzed by survival rate,objective response rate （ORR）,and toxicity.Furthermore,the analysis was further stratified by factors that could affect the treatment effects.Results Eight trials recruiting 1 546 patients with advanced or recurrent gastric cancer were included in the analysis.Overall,irinotecan therapy was associated with a 6％ improvement in survival rate,but this difference was not statistically significant （odds ratio （OR） 0.94; 95％ confidence interval （95％ CI） 0.70-1.27; P=-0.69）.However,irinotecan therapy had more frequent ORR than irinotecan-free arm （OR 1.70; 95％ CI 1.34-2.17; P ＜0.001）.Furthermore,irinotecan therapy was associated with a clinically and statistically significant increase in the risk for declined hemoglobin,hyponatremia,and diarrhea,but it also protected against thrombocytopenia risk when compared with irinotecan-free therapy.Conclusions There is no evidence to support the use of irinotecan therapy in patients with advanced or recurrent gastric cancer; however,given the significant advantage in ORR irinotecan therapy using combination regimens may be considered for further evaluation in subsets of patients who may benefit from this treatment.     

The Impact of Hyperthermotherapy plus Radiochemotherapy for Cervical Carcinoma on Long-term Survival and Toxicity

To evaluate the long-term survival, acute and late toxicity of the combination of hyperthermotherapy with radiochemotherapy on cervical carcinoma, 120 patients with stage Ⅱb, Ⅲb cervical carcinoma from 1993 to 1994 were randomly divided into four groups： Group RT （radiotherapy alone）, Group RCT （radiotherapy ＋ chmeotherapy）, Group RHT （radiotherapy ＋ hyperthermotherapy） and RCHT （radiotherapy ＋ chemotherapy ＋ hyperthermotherapy）. The 5-year survival rates of Group RT, RCT, RHT and RCHT were 70.0%, 66.7%, 76.7%, 76.6% respectively, with no significant differences among these four groups （p〉0.05）. There was an important finding that hyperthermotherapy could inhibit white blood cell decrease due to radiotherapy and/or chemotherapy. Toxicity of hyperthermotherapy plus radiotherapy to white blood cell was the smallest among those four groups, on the contrary, chemotherapy plus radiotherapy was the largest. There were no significant differences in gastrointestinal and genitourinary acute toxicity, rectal and bladder late toxicity among these four groups. On treatment heamoglobin was higher than pre-treatment heamoglobin among Group RT, RCT and RHT, on the contrary, on treatment heamoglobin of Group RCHT were lower than pre-treatment heamoglobin. Therefore, consider survival versus toxicity and survival versus cost-effective, we recommend hyperthermotherapy plus radiotherapy for cervical carcinoma.     

Fcγ receptor IIIA polymorphisms and efficacy of rituximab therapy on Chinese diffuse large B-cell lymphoma

Background Rituximab is used extensively in combination with chemotherapy to cure non-Hodgkin＇s lymphoma （NHL）, and not only accelerates short-term improvement, but also prolongs patient survival and decreases relapse. The aim of this study was to evaluate the impact of Fcγ receptor IliA （FcyRIIIA） gene polymorphisms on the response to rituximab therapy for newly diagnosed B-cell lymphomas. Methods Patients with newly diagnosed histologically-proven CD20-positive B-cell lymphoma were eligible for the study. All of the patients received rituximab combined with chemotherapy （CHOP）. The FcyRIIIA type was analyzed by PCR. The initial efficacy was assessed after 6 cycles and the long-term survival was determined. Results Thirty-four patients were recruited between October 2005 and April 2006. The FcyRIIIA distribution was as follows： 11 patients were VV, 5 were FF, and 18 were VE After a median of 6 cycles （range 4-8） of rituximab combined chemotherapy, the overall response rate was 79% （82% in the VV group, 83% in the VF group, and 60% in the FF group; P=0.04）. After a median follow-up time of 37 months （range 34-41）, there were 12 relapses among 27 responders （44%）; 5 of 9 patients （5/9） in the VV group, 5 of 15 patients （33%） in the VF group, and 2 of 3 patients （2/3） in the FF group （P=0.21）. The 1-year overall survival in the VV, FF, and VF groups was 80%, 60%, and 80%, respectively, and the 3-year overall survival was 58%, 40%, and 69%, respectively （P=0.08）. After analysis by COX regression, only the international prognosis index and response to initial treatment were significantly related to overall survival. Conclusions The distribution of FcyRIIIA polymorphisms in this B-cell lymphoma population shows that VF is most frequently expressed, followed by VV and FE Patients with the FcyRIIIA VV and VF types are more sensitive to the initial treatment of rituximab combined with chemotherapy and have superior long-term survival compared with those with FF. Nevertheless, FcyRIIIA polymorphisms do not predict prognosis independently.     

Treatment of advanced non-small cell lung cancer with extracorporeal high frequency thermotherapy combined with Chinese medicine

Objective： To observe the clinical efficacy and benefit response of extracorporeal high frequency thermotherapy （EHFT） combined with Chinese medicine （CM） in the treatment of patients with advanced non-small cell lung cancer. Methods： The study adopted a prospective, small sample and randomized controlled method, and the advanced non-small cell lung cancer patients were assigned to two groups according to the table of random digits, one having the treatment of EHFT combined with CM （the treatment group）, the other only with CM （the control group）. The patients in the treatment group were treated with EHFT one hour once per day, together with CM differentiation decoction, 250 mL orally taken, twice daily for 14 days as one cycle, and 3-4 cycles was performed. The patients in the control group were treated only with CM differentiation decoction using the same dose as the treatment group. The efficacies were evaluated after three to four cycles of treatment. Primary endpoints were disease control rate （DCR） and time to progression （TTP）. Secondary endpoints were overall survival time and 1-year survival rate. Results： Sixty-six patients accomplished the study. After the patients underwent different treatments, none of the patients got a complete response or partial response in both groups. In the treatment group, DCR was 72.2%, and 10 had progression of disease （28.8%）, while the DCR of the control group was 63.3%, and 11 had progression of disease （36.7%）; there was a significant statistical difference （P0.05）, suggesting that the combined regimen had superiority on the DCR. As for long-term efficacy, the median survival time （MST） of the treatment group was 7.5 months, TTP was 5.5 months, and 1-year survival rate was 21.4 %; in the control group, the results were 6.8 months, 4.5 months and 16.6% respectively. There was significant statistical difference on TTP （P0.05）, but no difference on MST or 1-year survival rate. Conclusion： EHFT combined with CM differentiation has better tolerance and short-term efficacy in the treatment of patients with advanced NSCLC.     

Polymorphism of methylenetetrahydrofolate reductase gene is associated with response to fluorouracil-based chemotherapy in Chinese patients with gastric cancer

Background The importance of polymorphisms in the methylenetetrahydrofolate reductase （MTHFR） gene for the prediction of the response to fluorouracil-based adjuvant chemotherapy in gastric cancer patients remains unclear. The aim of this study is to assess the predictive value of several polymorphisms of the MTHFR gene for clinical outcomes of gastric cancer patients treated with fluorouracil-based adjuvant chemotherapy in Chinese population. Methods Three hundred and sixty-two Chinese patients with gastric cancer were treated with fluorouracil-based adjuvant chemotherapy. DNA samples were isolated from peripheral blood collected before treatment. The three single nucleotide polymorphisms （SNPs） （rs1801131, rs1801133, rs2274976） genotypes of the MTHFR gene were determined by matrix- assisted laser desorption/ionization time-of-flight mass spectrometry （MALDI-TOF MS）. Results The average response rate for chemotherapy was 46.7%. Homozygous genotypes rs2274976G/G （X2=22.7, P 〈0.01） and rs1801131A/A （X2=14.3, P=0.008） were over-represented in responsive patients. Carriers of the rs2274976A allele genotypes （G/A and A/A） and of the rs1801131C allele genotypes （A/C and C/C）were prevalent in nonresponsive patients. In the haplotype association analysis, there was a significant difference in global haplotype distribution between the groups （X2=20.69, P=0.000 124）. Conclusions These results suggest that polymorphisms of the MTHFR gene may be used as predictors of the response to fluorouracil-based chemotherapy for gastric cancer patients in Chinese population. Well-designed, comprehensive, and prospective studies on determining these polymorphisms of MTHFR gene as clinical markers for predicting the response to fluorouracil-based therapy in gastric cancer patients is warranted.     

Effect of neoadjuvant chemotherapy on expressions of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67 in breast cancer

Background This study was designed in an attempt to determine the influence of neoadjuvant chemotherapy on estrogen receptor （ER）, progesterone receptor （PR）, human epidermal growth factor receptor 2 （Her-2）, and Ki-67 expressions in patients with breast cancer. Methods Pre- and post-neoadjuvant chemotherapy, paired-tumor specimens from 103 patients with breast cancer administrated with anthracycline or anthracycline combined taxane regimen were collected. Immunohistochemical staining for ER, PR, Her-2, and Ki-67 was performed by the DAKO EnVision method. Results Among the 103 cases, five patients （4.9%） had a complete response （CR）, 82 （79.6%） partial response （PR）, 15 （14.6%） stable disease （SD）, and one （0.9%） progressive disease （PD）, yielding an overall response rate （CR ＋ PR） of 84.5%. Nine patients achieved pathological CR. There was a significant decrease in the average index of Ki-67 post- neoadjuvant chemotherapy, compared with that before chemotherapy （24.1% vs. 39.7%, P 〈0.001）. After neoadjuvant chemotherapy, the changes of Ki-67 in different subtypes of breast cancer were different （P 〈0.001）, and these changes correlated with response to neoadjuvant chemotherapy （P 〈0.001）. No significant changes in immunohistochemical expression were observed for ER, PR and Her-2. Conclusions Neoadjuvant chemotherapy apparently reduced Ki-67 index in primary breast carcinomas, but profiles for ER, PR and Her-2 were not significantly different before and after neoadjuvant chemotherapy. The change of Ki- 67 correlated with molecular subtypes and response to neoadjuvant chemotherapy, suggesting that Ki-67 index was a surrogate marker to predict the treatment response of neoadjuvant chemotherapy.     

125I粒子组织间植入治疗局部晚期肺癌的对比研究

目的评价CT导向下^125I粒子植入治疗局部晚期肺癌的临床价值。方法CT导向下^125I粒子植入32例（A组）经一线化疗未控的局部晚期肺癌患者。32例患者病灶数48个,所有病灶与正常组织间有较清楚的边界,最大径4．5-7．5cm,平均5．5cm。全部病例均经病理证实。应用放射性^125I粒子源强为23．3-30．0MBq,肿瘤匹配周边剂量为100-150Gy。采用TPS计算布源,在cT导向下将^125I粒子植入瘤灶内。对照组为随机抽取一线化疗局部晚期肺癌病例30例（B组）。结果2个月后cT复查,A组局控率78．1％。一年生存率为65．0％,中位生存时间15个月。术中肺内会有少量渗出;4例出现气胸,肺压缩均在30％以内,经保守治疗好转;术后1周痰中带血15例。未见骨髓抑制等严重并发症。B组局控率43．3％。一年生存率为48．0％,中位生存时间11个月,骨髓抑制发生率46．3％。两者差异有统计学意义。结论放射性粒子植入治疗局部晚期肺癌临床疗效好,并发症发生率低,生活质量改善明显,近期效果好,是一种治疗局部晚期肺癌的简单、安全、有效的方法。     

高能聚焦超声热疗合并化疗治疗晚期胰腺癌近期疗效观察

目的:观察高能聚焦超声(HIFU)与GF(G:健择,F:氟尿嘧啶)方案化疗联合治疗晚期胰腺癌近期疗效和毒副作用。方法:40例晚期胰腺癌患者(经病理学证实34例)随机分为:A组为HIFU+GF方案化疗;B组为单纯GF方案化疗。结果:A组有效率50.0％,B组31.3％;A组临床受益率64.7％,B组为31.3％,两组比较差异有显著性(P<0.05)。主要毒性反应为白细胞减少和血小板减少。结论:HIFU+GF方案化疗联合治疗晚期胰腺癌有较好的疗效和耐受性。     

艾迪注射液联合FDH方案治疗晚期胃癌的临床分析

目的：分析艾迪注射液联合FDH方案化疗（观察组）与单纯FDH方案化疗（对照组）对晚期胃癌的疗效、副反应及对免疫功能的影响。方法：观察组36例晚期胃癌患者在采用FDH方案化疗同期加用艾迪注射液，对照组30例晚期胃癌患者单用FDH方案治疗。结果：观察组有效率为38．9％，高于对照组30％，但差异无显著性（P＞0．05）。观察组治疗前后免疫功能的改变、副反应、胃肠反应均明显低于对照组，差异有显著性（P＜0．05）。结论：艾迪联合FDH方案治疗晚期胃癌，疗效显著，并降低了FDH化疗方案对免疫功能、胃肠道的影响及副反应。     

艾易舒注射液联合化疗治疗非小细胞肺癌临床疗效观察

目的:观察斑蝥酸钠维生素B6注射液(艾易舒)对晚期肺癌患者化疗的协同治疗作用。方法:60例患者随机分为两组,治疗组30例,应用艾易舒合并化疗;对照组30例,单用化疗,比较两组抗肿瘤疗效、临床症状变化、化疗不良反应的发生情况。结果:治疗组30例,抗肿瘤有效率为40%,对照组30例,抗肿瘤有效率为33.3%;治疗组的症状改善率为86.7%,对照组的症状改善率为53.3%;治疗组KPS评分增高率为50.0%,对照组KPS评分增高率为23.3%;治疗组白细胞减少和消化道反应发生率分别为:30.0%、23.3%,对照组白细胞减少和消化道反应发生率分别为:46.7%、43.3%。结论:斑蝥酸钠维生素B6注射液具有增强化疗疗效、改善患者症状、减少化疗毒副反应的作用。     

高能聚焦超声联合吉西他滨治疗老年人晚期胰腺癌的临床研究

目的：观察高能聚焦超声（HIFU）联合吉西他滨（GEM）治疗老年人晚期胰腺癌的疗效和安全性.方法：回顾性分析2008年10月至2010年6月本科室收治的30例老年人晚期胰腺癌患者的临床资料,分为2组：A组（8例）行单纯HIFU治疗,B组（22例）行HIFU联合GEM治疗.治疗结束时比较2组患者疗效和临床受益反应率,记录2组患者治疗过程中的不良反应.结果：A组治疗有效率为37.5%（3/8）,临床受益反应率为50.0%（4/8）;B组治疗有效率为63.6%（14/22）,临床受益反应率为72.7%（16/22）,2组比较差异均具有统计学意义（均P〈0.05）.A组患者不良反应轻微,B组患者的不良反应主要为化疗所致的骨髓抑制.结论：HIFU联合GEM治疗老年人晚期胰腺癌具有较好的临床疗效,且不良反应少.     

术后早期腹腔泵灌注化疗对胃癌的临床疗效分析

目的 探讨术后早期腹腔灌注化疗在胃癌治疗中的临床价值。方法 76例进展期胃癌行胃癌根治术后,依据化疗方法的不同,分为两组:治疗组40例,采取术中植入腹腔泵于皮下,术后通过腹腔泵每周给药1次;对照组36例,采取外周静脉大剂量冲击化疗。结果 治疗组12个月,24个月,36个月生存率分别为95％、75％和30％;对照组分别为72％、41％和11％(P<0.05,P<0.01,P<0.01)。治疗组术后发生肝转移,腹腔种植转移和其它转移分别为7.5％、12％、15％;对照组分别为33％、17％和12％(P<0.05,P<0.05,P<0.05)。治疗组患者的生存质量明显改善,白细胞下降,消化道反应,肝、肾、骨髓毒性较对照组低。结论 术后早期经腹腔行腹腔灌注化疗可明显提高胃癌患者生存率,减少癌转移,提高生存质量。     

高强度聚焦超声治疗晚期胰腺癌25例

目的观察高强度聚焦超声治疗晚期胰腺癌的近期疗效及安全性。方法应用高强度聚焦超声肿瘤治疗机治疗晚期胰腺癌25例。结果临床受益率76.00%（19/25）,无效率24.00%（6/25）。癌性疼痛缓解率80%（16/20）。所有病例均未出现胰液外漏、腹腔内出血、胃肠道损伤等相关并发症。结论高强度聚焦超声治疗晚期胰腺癌能取得一定的疗效,治疗安全性高。     

IL—2／LAK与放,化疗联合治疗晚期恶性肿瘤

目的：探讨ＩＬ－／ＬＡＫ细胞与放疗和／或化疗联合治疗晚期恶性肿瘤的价值。方法：本组共３０例,其中单纯ＩＬ－２／ＬＡＫ细胞治疗５例（包括２例ＴＩＬ细胞胸腹腔灌注）,ＩＬ－２／ＬＡＫ细胞联合放疗１８例（包括１例动脉灌注）,ＩＬ－２／ＬＡＫ细胞联合化疗４例）包括１例动态灌注）,ＩＫ－２／ＬＡＫ细胞联合放疗和化疗３例。结果：完全缓解率２０．０％（６／３０）,总有效率５０．０％（１５／３９）,其中单纯ＩＬ－     

经皮经锁骨下动脉植入药盒系统治疗胰头癌的临床疗效

目的 :探讨药盒系统在手术不能切除胰头癌治疗中的临床价值。方法 :手术无法切除的胰头癌 12 6例 ,分为两组。A组 :88例采用经皮经左锁骨下动脉植入药盒系统 ,术后经药盒化疗。B组直接静脉给药全身化疗。化疗方案 :采用FMA方案 ,7d为一周期 ,间隔 1～ 2m重复下一周期。结果 :A组共行局部药盒系统化疗 2～ 10次 ,平均 7 6次。完全缓解 (CR) 4例 ,部分缓解 (PR) 49例 ,有效率 (CR +PR) 60 2 % ;生存期 3～ 3 4m ,中位生存时间 13 5m。B组完成化疗 1～ 7次 ,平均 3 8次。无CR病例 ,PR10例 ,有效率 2 7 3 %。生存期 1～ 13m。B组完成化疗 1～ 7次 ,平均 3 8次。无CR病例 ,PR10例 ,有效率 2 7 3 %。生存期 1～ 13m中位生存期 6 2m ,两组对比在有效率和生存期方面均有显著性差异 (P <0 0 5 )。在临床症状方面 ,A组中 5 6例病人表现为顽固性疼痛 ,化疗 2～ 3w后 2 7例疼痛完全消失 ,2 2例不同程度缓解 ,占 87 5 %。B组疼痛 3 2例 ,化疗后疼痛完全消失 4例 ,缓解 6例 ,占 3 1 2 %。化疗的毒副作用。A组无严重的肝肾、心脏和骨髓损害。 2 5例在化疗中出现轻微的胃肠反庆和白细胞降低 ,占 2 8 3 % ,均不影响继续化疗。B组 3例出现严重骨髓抑制 ,1例死亡 ,肝肾功能也有不同程度的损害 ,发生胃肠道反应和白细胞     

高强度聚焦超声治疗晚期胰腺癌17例临床疗效分析

目的观察高强度体外聚焦超声(HIFU)治疗晚期胰腺癌的安全性及近期疗效。方法应用FEP-BYO2肿瘤超声治疗机治疗胰腺癌17例,共接受治疗135次(平均每例8次)。结果完全缓解率(CR)11.76%(2/17),部分缓解率(PR)58.82%(10/17),总有效率70%(CR PR)。临床受益反应率(CBR)82.36%,无效率17.64%(3/17)。癌性疼痛缓解率80%(8/10)。所有病例治疗时均未出现胰液外漏、腹腔内出血、胃肠道损伤等相关并发症。结论HIFU治疗晚期胰腺癌能取得一定的疗效,治疗安全性高,值得临床进一步观察研究。