放射与放射结合瘤内药物注射治疗原发性大肝癌的疗效观察

本文报告62例大肝癌(肿瘤≥8cm或≥50％肝脏体积)患者经病理学确诊后,给予全肝移动条放射或结合瘤内药物注射的治疗结果。结果提示,放疗结合瘤内药物注射组其治后1年生存率与单纯放疗组近似,而2年生存率则有显著差异(P<0.05)。这说明放疗结合瘤内药物注射有可能提高大肝癌治疗的远期疗效。瘤内药物注射后,患者除有局部轻度胀痛感外,未发现其他副作用。     

直肠癌放化疗患者心理问题与生活质量评估

目的 探讨直肠癌放化疗患者的心理问题与生活质量及相关分析.方法 共入组54例患者,入院后完成抑郁自评量表(SDS)、焦虑自评量表(SAS)和SF-36评估.结果 局部晚期或术后复发患者较术后常规放化疗患者表现出更高的焦虑和抑郁(P＜0.05),表现出更多的消极应对方式(P＜0.05),相应生活质量评估中情感角色、生命活力、心理健康及社会功能水平明显偏低(P＜0.05).抑郁、焦虑程度与生活质量评估水平具有明显相关性(P＜0.05).结论 局部晚期或术后复发患者只能接受姑息性放化疗,表现出较高水平的焦虑和抑郁,生活质量及免疫学功能均受到较大的影响,常提示预后不良,应该受到临床医护人员的特殊关注.     

Fanconi贫血家族与白血病

 本文报道了2例Fanconi贫血（FA）兄弟，发病于10岁前。都患有全血细胞减少伴皮肤色素沉着，拇指缺如，生殖器发育不良等先天性畸形。经中西医治疗5年后，其中1例转变为急性白血病死亡，另1例一般健康状态良好。FA转变成白血病至今国内未见报道。本例家族的情形说明FA与原发性再障有质的不同。     

生存质量在中医肿瘤学综合效评价中的作用

随着医学模式的转变,人们将生命的目标从追求生存的数量转为生存的质量,生存质量被广泛地应用到医学领域中。对恶性肿瘤的治疗,提高患者的生存质量已成为主要目的之一。现代医学治疗恶性肿瘤的评价标准在强调生存质量的今天,已显出它的弊端,用它来评价中医药的疗效更显片面。因此,将生存质量的评价方法引入到中医肿瘤学治疗领域中,有助于解决中医药疗效无法客观评定的问题。     

Expanding Public‐Private Collaborations to Enhance Cancer Drug Development: A Report of the Institute of Medicine's Workshop Series, “Implementing a National Cancer Clinical Trials System for the 21st Century”

Since their inception in the 1950s, the National Cancer Institute‐funded cancer cooperative groups have been important contributors to cancer clinical and translational research. In 2010, a committee appointed by the Institute of Medicine (IOM) of the National Academy of Sciences completed a consensus review on the status of the U.S. publicly funded cancer clinical trials system. This report identified a need to reinvigorate the cooperative groups and provided recommendations for improving their effectiveness. Follow‐up workshops to monitor progress were conducted by the IOM's National Cancer Policy Forum and the American Society of Clinical Oncology (ASCO) in 2011 and 2013. One of the key recommendations of the IOM report was a call for greater collaboration among stakeholders in cancer research. In particular, more active engagement and better alignment of incentives among the cooperative groups, the National Cancer Institute, the U.S. Food and Drug Administration, and the biopharmaceutical industry were identified as essential to achieving the promise of oncology drug development. This review, based on presentations and discussion during the IOM‐ASCO workshops, outlines the progress and remaining challenges of these collaborations.     

不同麻醉方式对肺癌根治术患者血流动力学的影响分析

目的：对比分析不同麻醉方式对肺癌根治术患者血流动力学的影响,为肺癌根治术选用理想的麻醉方式提供一定的依据。方法选取行肺癌根治术患者90例为研究对象,随机分为观察组和对照组各45例,观察组行舒芬太尼复合丙泊酚靶控注射,对照组行舒芬太尼静脉恒速注射,丙泊酚靶控输注维持肺癌根治术麻醉。记录麻醉前、切皮后5 min、手术开始30 min、拔管时各时间点的血流动力学指标的变化;记录患者睁眼时间及拔管时间、麻醉镇痛效果,并记录应用麻醉剂后引起的心血管抑制和呼吸抑制等不良反应发生率。结果经研究比较,两组麻醉均可导致患者的收缩压、舒张压降低及HR减慢,与麻醉前相比,切皮后5 min及手术开始30 min后两组血流动力学均发生明显改变,差异具有显著性（P＜0．05）;观察组血流动力学改变较对照组略平稳,组间比较无显著差异（P＞0．05）;观察组睁眼时间及拔管时间均短于对照组,差异具有显著性（P＜0．05）;观察组镇痛有效率高于对照组,差异具有显著性（P＜0．05）。结论舒芬太尼静复合丙泊酚靶控注射用于肺癌根治术患者的手术麻醉,镇痛效果确切,术中血流动力学较为稳定,能够显著缩短睁眼时间及拔管时间,是一种较为理想的麻醉和镇痛方法。     

Action Levels on Dose and Anatomic Variation for Adaptive Radiation Therapy Using Daily Offline Plan Evaluation: Preliminary Results

Purpose

This study aimed to develop action levels for replanning to accommodate dosimetric variations resulting from anatomic changes during the course of treatments, using daily cone beam computed tomography (CBCT).