非小细胞肺癌化疗研究进展

肺癌是最常见的恶性肿瘤，其中非小细胞肺癌(NSCLC)占80％。而80％的NSCLC为晚期(Ⅰ、Ⅳ期)患者，已失去手术机会。故化疗在晚期NSCLC的治疗中占重要地位。现将NSCLC的化疗研究进展概述如下。     

多西紫杉醇加铂类2周给药治疗晚期非小细胞肺癌患者的疗效、毒副反应和生活质量

在由癌症引起的死亡病例中肺癌约占1/3.其中75％～80％为非小细胞肺癌(NSCLC)[1].患者确诊为NSCLC时约有60％～70％已属于晚期[2].晚期NSCLC已不适合手术治疗,其治疗现阶段多采用化疗作为其主要治疗方案[3].多个临床试验表明铂类与多西紫杉醇联合治疗晚期NSCLC较传统化疗方案在临床疗效和不良反应方面均有所提高,能够延长患者生存期并提高其生活质量[4].目前临床多采用多西紫杉醇与铂类药物联合化疗3 w方案作为晚期NSCLC化疗的一线标准方案[5].本研究将评估采用多西紫杉醇加铂类2 w方案治疗NSCLC患者的疗效、不良反应以及对生活质量的影响.     

吉西他滨联合卡铂治疗老年晚期非小细胞肺癌的临床观察

老年非小细胞肺癌（NSCLC）患者由于生理机能减退，对化疗耐受性下降。寻找适合老年患者，疗效确切，毒副反应能耐受的联合化疗方案十分迫切。吉西他滨（gemcitabine）是治疗晚期NSCLC的新型化疗药物，不良反应小，与铂类药物联合应用治疗晚期NSCLC目前受到推崇。本文采用吉西他滨联合卡铂治疗43例老年晚期NSCLC患者，旨在于观察其疗效和不良反应。     

GC化疗方案联合安罗替尼胶囊对晚期非小细胞肺癌患者生存状况的影响及其机制研究

背景 安罗替尼胶囊是目前临床研究的热点药物,但其联合GC化疗方案对晚期非小细胞肺癌(NSCLC)患者生存状况的影响尚未完全明确.目的 探讨GC化疗方案联合安罗替尼胶囊对晚期NSCLC患者生存状况的影响及其机制,以为晚期NSCLC患者临床方案的制定提供一定参考.方法 选取2018年6月—2019年5月自贡市第四人民医院收...     

紫杉醇脂质体、顺铂联合重组人血管内皮抑素治疗晚期非小细胞肺癌的疗效及安全性

正肺癌病理分型中以非小细胞肺癌(NSCLC)为主,由于缺乏明显的临床症状和体征,患者就诊时大多已经属于晚期,丧失了手术机会,化疗便成为主要的治疗手段。紫杉醇联合顺铂是NSCLC经典的化疗方案,能显著改善患者的临床症状,提高晚期肺癌患者的生存率。重组人血管内皮抑素发挥作用的     

培美曲塞在肺癌治疗中的作用

目前肺癌的发病率和病死率居恶性肿瘤之首，由于缺乏有效的早期诊断手段，大部分患者发现肿瘤时已为晚期（Ⅲ、Ⅳ期）。大部分晚期肺癌的治疗目的是减轻症状、延长患者生存期。目前非小细胞肺癌（NSCLC）的治疗并无特殊规定，美国临床肿瘤协会（ASCO）制定的指南推荐，以铂类为基础的双药化疗方案为治疗肺癌的一线化疗方案。同样，多数小细胞肺癌（SCLC）发现时也已为广泛期，治疗目的与转移性NSCLC类似，推荐的标准化疗方案亦是含铂的双药化疗方案。故为晚期NSCLC和SCLC患者寻找一个更有效或毒性反应较小的治疗方法具有重要意义。[第一段]     

培美曲塞治疗老年晚期非小细胞肺癌患者不良反应的护理

肺癌在众多恶性肿瘤中发病率高,居男性发病第一位,女性发病第二位。大部分肺癌患者确诊时已属晚期,失去手术和放疗机会,化疗成为主要的治疗措施之一。非小细胞肺癌（non-small cell lung cancer,NSCLC）占全部肺癌的80％左右,近年来老年化趋势明显,老年晚期NSCLC患者,由于器官功能减退,免疫力低下等原因,选用不含铂类的第三代单药方案可能更让患者获益。培美曲塞为晚期NSCLC的二线治疗药物,虽有一定的副反应,但临床耐受性较好,比较适合于老年人使用。我科自2006年05月以来,使用培美曲塞治疗老年晚期NSCLC患者36例,总结了在化疗过程中该药不良反应的发生情况及其护理经验,现报道如下。     

HER2/neu靶向治疗与非小细胞肺癌

在世界范围内,肺癌是发病率最高的肿瘤之一,同时也是病死率最高的肿瘤。人们估计,在美国2001年新诊断了169500例肺癌患者,死亡157400例[1]。根据临床表现和细胞学类型,肺癌分为小细胞肺癌(SCLC)和非小细胞肺癌(NSCLC),85%肺癌患者的病理类型为NSCLC。绝大部分NSCLC患者就诊时已处于晚期(ⅢB期或Ⅳ期)。这些晚期患者已经失去手术和放疗的机会,临床上只能采用全身化疗的方法进行治疗。目前对于晚期肺癌,最好的化疗方案的有效率也只有15%～21%,患者的中位生存期为7～8个月。因此,近些年来人们根据肿瘤细胞的分子生物学特征,开发了针对…     

晚期非小细胞肺癌的化疗现状与思考

一、概述 肺癌是恶性肿瘤中发病率最高的肿瘤之一,其病死率在所有肿瘤中位居第一.非小细胞肺癌（NSCLC）占肺癌患者的80%,其中60%～70%在明确诊断时已经达到局部晚期或晚期.对这部分患者来说,全身治疗是主要的治疗手段,包括化疗和靶向治疗.但是,无论化疗或是靶向治疗,都有其不可替代的优势和缺陷.近些年来,越来越多的人认识到了NSCLC的异质性.     

晚期非小细胞肺癌患者血清环状RNA VMP1、PIP5K1A水平与含铂双药化疗效果及预后的关系

目的 观察晚期非小细胞肺癌（NSCLC）患者血清环状RNA VMP1、PIP5K1A水平变化,探讨其与化疗效果及预后的关系探讨血清VMP1、PIP5K1A与晚期非小细胞肺癌化疗效果及预后的关系。方法 选择晚期NSCLC患者118例作为NSCLC组,另选择同期健康体检者60例作为对照组。采集两组空腹静脉血,实时荧光定量PCR法检测血清VMP1、PIP5K1A。于化疗前及化疗后行胸部CT检查评估化疗效果,随访1年记录患者生存情况。比较不同临床特征的晚期NSCLC患者血清VMP1、PIP5K1A水平。根据患者血清VMP1、PIP5K1A水平的平均值将NSCLC患者分为VMP1高水平者及低水平者、PIP5K1A高水平及低水平者,绘制Kaplan-Meier生存曲线并比较VMP1、PIP5K1A高低水平者的1年生存率。采用多因素Cox比例风险模型分析晚期NSCLC患者血清VMP1、PIP5K1A水平对预后的影响。结果 NSCLC组血清VMP1、PIP5K1A水平均高于对照组（P均<0.01）。TNM分期为Ⅳ期、低分化的晚期NSCLC患者血清VMP1、PIP5K1A水平分别高于TNM分期为Ⅲ...     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.