营养干预对鼻咽癌患者放化疗耐受性及生活质量的影响

目的探讨营养干预对鼻咽癌患者放化疗耐受性及生活质量的影响。方法将80例鼻咽癌初治患者随机分为干预组和对照组,各40例,观察两组患者放化疗预期完成情况及放射剂量达40Gy时生活质量评分(QOL)比较。结果干预组97.5%(39/40)而对照组仅72.5%(29/40)按预期的剂量和时间完成放化疗;放射剂量达40Gy时,QOL评分≥41分者,干预组为82.5%(33/40),对照组为47.5%(19/40),差异有统计学意义(p<0.05)。结论营养干预可有效地提高鼻咽癌患者放化疗耐受性、减轻毒副反应,提高生活质量。     

多学科协作营养干预对宫颈癌放疗患者的应用效果及作用研究

目的：研究多学科协作的营养干预在宫颈癌放疗患者中的应用价值。方法：选择2020年1—2021年7月期间接受放疗的50例宫颈癌患者,分为对照组与研究组各25例。对照组实施常规营养干预,研究组实施多学科协作营养干预,观察两组营养指标、不良并发症发生情况、生活质量。结果：干预后研究组BMI值、白蛋白及前白蛋白指标均显著高于对照组(P<0.05),研究组血小板或白细胞计数降(12%)、急性胃肠道反应(24%)、放射性结直肠炎或尿道膀胱炎(8%)不良并发症发生机率均显著低于对照组(P<0.05),研究组生理维度、社会维度、情感维度、功能维度指标均显著高于对照组(P<0.05)。结论：宫颈癌放疗患者实施多学科营养干预有利于改善其营养状态,减少并发症,提高生活质量。     

心理干预对宫颈癌同期放化疗患者生存质量的影响

目的：探讨接受放化疗宫颈癌患者生存质量及心理干预对其的影响。方法：对84例宫颈癌患者按照随机数字表法分为两组,一组给予心理干预（干预组）,一组未给予心理干预（对照组）。采用欧洲癌症研究与治疗组织研制的生存质量核心量表,对两组进行生存质量测量和评价,研究心理干预对生存质量的影响。结果：治疗后,干预组各项生存质量指数如功能量表及症状量表均明显高于对照组,比较差异均有统计学意义（P〈0.05）。结论：宫颈癌患者同期放化疗实施心理干预,能显著提高患者的生存质量。     

同步放化疗治疗中晚期宫颈癌的疗效观察

目的：探讨中晚期宫颈癌应用同步放化疗治疗的临床效果。方法：随机选取2018年8月～2020年2月于本院收治的60例中晚期宫颈癌患者进行临床疗效研究,其中对照组30例采用单纯放疗治疗（疾病类型：腺癌7例、鳞癌14例、腺鳞癌9例;临床分期：Ⅱb8例、Ⅲa14例、Ⅲb5例、IVa3例）;观察组30例采用同步放化疗治疗（疾病类型：腺癌6例、鳞癌15例、腺鳞癌9例;临床分期：Ⅱb7例、Ⅲa14例、Ⅲb6例、IVa3例）。对比两组患者的临床疗效、不良反应、1年生存率、局部复发率、远处转移率。结果：采用同步放化疗的观察组治疗总有效率高达93.33%,显著优于对照组的56.67%;对照组肝功能损伤5例、胃肠道反应10例、放射性膀胱炎5例、骨髓抑制14例与观察组肝功能损伤5例、胃肠道反应9例、放射性膀胱炎6例、骨髓抑制13例差异不显著,P>0.05,无统计学意义;此外观察组1年生存差异对比显著,P<0.05,有统计学意义。两组患者,观察组1年生存率73.33%、局部复发率16.67%、远处转移率13.33%显著优于对照组1年生存率46.67%、局部复发率40.00%、远处转移率40.00%。...     

化疗联合同步放疗在晚期宫颈癌中的应用价值

目的：探讨针对晚期宫颈癌患者开展同步放化疗的临床效果.方法：选取本院2008年5月至2013年5月收治的晚期宫颈癌患者170例,随机将样本分为对照组与观察组各85例,对照组给予单纯放疗,观察组采用同步放化疗.结果：观察组患者的近期疗效与远期疗效均显著高于对照组,具有统计学意义（P〈0.05）. 结论：针对晚期宫颈癌患者开展同步放化疗可显著提高患者的治疗效果,延长生存时间,是治疗局部晚期宫颈痛行之有效的方法.     

Hogan理论联合多样性心理干预在同步放化疗宫颈癌患者护理中的应用效果

目的:分析对同步化疗宫颈癌患者运用Hogan理论联合多样性心理干预的临床价值.方法:选择我院2020年1月至2021年4月收治的90例同步放化疗宫颈癌患者为对象,随机分两组,观察组与对照组各45例,对照组运用心理干预护理,观察组在对照组基础上联合Hogan理论,观察两组患者心理状态与护理满意度.结果:护理干预后对照组S...     

Hogan理论联合多样性心理干预在同步放化疗宫颈癌患者护理中的应用效果

目的探究Hogan理论联合多样性心理干预在同步放化疗宫颈癌患者护理中的应用效果。方法选取2017年1月-2018年12月大连市某医院收治的宫颈癌患者90例作为研究对象,采用随机数字表法分为研究组及对照组,每组45人,研究组患者采用Hogan理论联合多样性心理干预进行护理,对照组患者仅进行多样性心理干预,比较2组患者焦虑抑郁情况、健康知识掌握程度以及生命质量。结果出院时,研究组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)评分分别为(36.58±4.24)分及(35.59±2.93)分,均低于对照组的(41.27±3.20)分及(40.22±3.48)分,且差异均有统计学意义(P0.05);研究组患者掌握了宫颈癌易感因素、感染途径、基础知识、预防和治疗4个方面内容的人数比例分别为86.67%,88.89%,84.44%及80.00%,均高于对照组的46.67%,48.89%,44.44%及44.44%,且差异均有统计学意义(P0.05);研究组患者在生命质量测定量表心理领域、生理领域、社会关系领域、独立性领域及环境领域得分分别为(3.71±0.32)分、(3.77±0.45)分、(3.49±0.39)分、(3.63±0.29)分及(3.74±0.44)分,均高于对照组的(2.42±0.41)分、(1.88±0.37)分、(2.17±0.54)分、(1.88±0.31)分及(3.01±0.37)分,且差异均有统计学意义(P0.05)。结论 Hogan理论联合多样性心理干预有助于宫颈癌患者心理状态的改善,能够提高患者对健康知识的掌握程度,促进其生命质量的改善,临床应用效果良好。     

局部晚期宫颈癌同步放化疗疗效观察

目的观察局部晚期宫颈癌患者采取同步放化疗治疗的临床效果及不良反应。方法选取170例局部晚期宫颈癌患者,并随机分为两组,85例采取同步放化疗为观察组,85例采取单纯放射治疗为对照组,分别对两组患者近期疗效、远期疗效及不良反应发生情况进行统计分析。结果观察组治疗总有效率为60.00%,对照组治疗总有效率为41.18%,两组差异有统计学意义(P﹤0.05)。随访所有患者1～3年期间,观察组复发率明显低于对照组,3年生存率明显高于对照组,差异有统计学意义(P﹤0.05)。观察组35(41.17%)例早期发生消化道症状,对照组15(17.6%)例早期发生消化道症状,差异有统计学意义(P﹤0.05)。观察组早期结直肠反应、膀胱反应发生率分别为17.6%(15/85)和15.29%(13/85),对照组分别为15.29%(13/85)和12.94%(11/85),观察组10.59%(9/85)发生放射性直肠炎,对照组7.06%(6/85)发生放射性直肠炎,两组比较差异均无统计学意义。结论局部晚期宫颈癌患者采用同步放化疗治疗,可提高肿瘤局部控制率,提高短期生存率,而且化疗引起的不良反应患者能耐受,不影响放疗进程,值得临床推广使用。     

磁共振弥散加权成像在宫颈癌放化疗疗效早期评估作用

目的：评估宫颈癌放化疗应用磁共振弥散加权成像(DWI)进行早期评估的作用效果。方法：选择本院经手术或宫颈病理活检诊断确诊的60例宫颈癌患者作为观察组,选择同期接受检查的非盆腔疾病患者60例作为对照组,术前开展磁共振成像(MRI)与DWI检查,比较两组检查时表现扩散系数(ADC)在不同病理与疗效时的数值差异变化。结果：对照组开展DWI检查显示,T1WI为均匀等信号,T2WI为多层样改变,宫颈管内黏液呈高信号,宫颈黏膜皱襞与子宫肌外层为中等信号,宫颈纤维基质为低信号;宫颈管内膜ADC值为(1.35±0.17)×10-3mm²/s,结合带ADC值为(1.54±0.15)×10-3mm²/s,肌层ADC值为(2.02±0.22)×10-3mm²/s。观察组宫颈癌患者的T1WI为等信号,T2WI呈均匀或混杂稍高信号影,DWI呈高信号,平均ADC值为(0.95±0.13)×10-3mm²/s,与对照组正常宫颈平均ADC相比更低,有统计差异(P<0.05)。宫颈鳞癌的ADC值(0.89±0.12)×10-3...     

同步放化疗对晚期宫颈癌的疗效观察

目的探讨局部晚期宫颈癌的最佳治疗方法。方法将患者分为同步放化疗组和单纯放疗组,观察局部控制率和生存率。结果同步放化疗组局部控制率和生存率高于单纯放疗组。结论在晚期局部宫颈癌的治疗中,同步放化疗优于单纯放疗。     

Impact of concurrent chemotherapy on definitive radiotherapy for women with FIGO IIIb cervical cancer

The purpose of this retrospective study is to investigate the impact of concurrent chemotherapy on definitive radiotherapy for the International Federation of Gynecology and Obstetrics (FIGO) IIIb cervical cancer. Between 2000 and 2009, 131 women with FIGO IIIb cervical cancer were treated by definitive radiotherapy (i.e. whole pelvic external beam radiotherapy for 40–60 Gy in 20–30 fractions with or without center shielding and concomitant high-dose rate intracavitary brachytherapy with 192-iridium remote after loading system for 6 Gy to point A of the Manchester method). The concurrent chemotherapy regimen was cisplatin (40 mg/m²/week). After a median follow-up period of 44.0 months (range 4.2–114.9 months) and 62.1 months for live patients, the five-year overall survival (OS), loco-regional control (LRC) and distant metastasis-free survival (DMFS) rates were 52.4, 80.1 and 59.9%, respectively. Univariate and multivariate analyses revealed that lack of concurrent chemotherapy was the most significant factor leading to poor prognosis for OS (HR = 2.53; 95% CI 1.44–4.47; P = 0.001) and DMFS (HR = 2.53; 95% CI 1.39–4.61; P = 0.002), but not for LRC (HR = 1.57; 95% CI 0.64–3.88; P = 0.322). The cumulative incidence rates of late rectal complications after definitive radiotherapy were not significantly different with or without concurrent chemotherapy (any grade at five years 23.9 vs 21.7%; P = 0.669). In conclusion, concurrent chemotherapy is valuable in definitive radiotherapy for Japanese women with FIGO IIIb cervical cancer.     

放化疗同步治疗晚期宫颈癌的临床观察

目的：观察放化疗同步治疗对晚期宫颈癌的临床治疗效果。方法对2008年5月至2012年7月广东省深圳市蛇口人民医院收治的晚期宫颈癌患者,随机分为对照组及实验组,均进行放射治疗,而实验组患者再配合化学辅助治疗,观察两组治疗效果。结果治疗后实验组肿瘤最大径线小于对照组,且差异具有统计学意义（t＝4．321,P＜0．05）。实验组患者有效率高于对照组,差异具有统计学意义（χ2＝4．71,P＜0．05）。实验组骨髓抑制和消化道反应比例均高于对照组,且差异具有统计学意义（χ2值分别为7．38和7．66,均P＜0．05）。两组患者生存率逐年递减,实验组1年、3年、5年生存率高于对照组,且差异具有统计学意义（χ2值分别为6．543,6．542,6．541,均P＜0．05）。结论采用放化疗同步治疗患者晚期宫颈癌效果显著。     

自身免疫细胞与放疗联合治疗对宫颈癌患者生活质量和免疫功能的影响

目的探讨自身免疫细胞与放疗联合治疗宫颈癌临床疗效,分析对宫颈癌患者生活质量及免疫功能的影响。方法选取2012年5月至2015年6月浙江大学医学院附属第二医院放疗科收治的85例宫颈癌患者为研究对象,分为对照组（n=42）和观察组（n=43）,对照组患者单纯放疗,观察组给予自身免疫细胞与放疗联合治疗,观察各组临床疗效,比较治疗前后两组患者免疫功能及治疗后生活质量。结果观察组总有效率为86.05%,对照组为64.28%,两组比较具有统计学差异（χ2=5.409,P=0.02）。对照组治疗后CD3＋、CD4＋、CD8＋细胞绝对值明显低于治疗前（t值分别为11.036、7.624、14.379,均P〈0.05）,观察组明显高于治疗前（t值分别为15.996、12.241、13.981,均P〈0.05）,治疗后两组CD3＋、CD4＋、CD8＋细胞绝对值比较有统计学差异（t值分别为22.758、20.839、27.140,均P〈0.05）。治疗后两组患者生存质量评分均明显高于治疗前（t对照组值分别为3.378、4.022、3.320、3.864,t观察组值分别为6.984、7.289、5.389、7.017,均P〈0.05）,观察组治疗后生存质量评分显著高于对照组（t值分别为3.609、3.386、3.009、4.417,均P〈0.05）。治疗后Ⅰ~Ⅱ期、Ⅲ~Ⅳ期两组患者生存质量评分均明显高于治疗前（tⅠ~Ⅱ期值分别为8.843、5.040、9.026、3.864,tⅢ~Ⅳ期值分别为5.534、5.314、9.604、10.210,均P〈0.05）,治疗后生存质量评分Ⅰ~Ⅱ期高于Ⅲ~Ⅳ期（t值分别为4.216、3.391、5.895、4.812,P〈0.05）。对照组出现骨髓抑制3例,消化道反应3例,观察组出现消化道反应3例,两组不良反应发生率比较无统计学差异（χ2=1.199,P=0.271）。结论自身免疫细胞与放疗联合治疗宫颈癌临床疗效显著,可通过提高患者免疫功能,提升患者生活质量。     

Orem自理理论在宫颈癌化疗患者中的应用效果分析

目的 探讨Orem自理理论在宫颈癌化疗患者护理中的应用效果。方法 将2019年10月—2020年9月在本院接受宫颈癌化疗的74例患者作为研究对象,按随机数字表法分为2组,每组各37例。对照组实施常规护理,观察组实施以Orem自理理论为指导的护理。比较2组干预前后癌因性疲乏、自我护理能力及生活质量。结果 干预前,2组Piper癌因性疲乏自评修正量表(RPFS)、自我护理能力量表(ESCA)、癌症患者生活质量测定量表(EORTC QLQ-C30)评分比较,差异无统计学意义(t=0.257、0.169、0.220,P值均>0.05);干预后,观察组RPFS评分为(13.44±2.85)分,低于对照组的(18.35±3.46)分,ESCA评分为(152.95±18.63)分,高于对照组的(126.63±16.35)分,差异具有统计学意义(t=6.663、6.459,P值均<0.001);观察组EORTC QLQ-C30评分为(70.28±9.67)分,高于对照组的(61.23±8.54)分,差异有统计学意义(t=4.267,P<0.001)。结论 Orem自理理论能够减轻宫颈癌化疗患者癌因性疲乏,并提高其自我护理能力和生活质量。     

两种联合放化疗方案治疗Ⅱ～Ⅳ期宫颈癌比较研究

目的：探讨紫杉醇脂质体与铂类单药化疗联合盆腔三维适形放疗治疗Ⅱ～Ⅳ期宫颈癌临床疗效和安全性差异。方法研究对象选取四川省自贡市第三人民医院妇产科2006年4月至2014年8月收治的Ⅱ～Ⅳ期宫颈癌患者共98例,采用随机抽样方法分为A组（49例）和B组（49例）,分别在盆腔三维适形放疗基础上同期采用铂类和紫杉醇脂质体治疗;比较两组患者临床近期疗效,随访生存率,治疗前后KPS评分及药物毒副作用发生率等。结果两组患者临床近期疗效比较差异无统计学意义（χ2＝0．45,P＞0．05）,两组患者随访1年生存率和无进展生存率比较差异均无统计学意义（χ2值分别为0．54、1．33,均P＞0．05）。两组患者治疗前KPS评分无显著性差异（t＝1．33,P＞0．05）,治疗后KPS评分均显著增加（t值分别为3．65、4．17,均P＜0．05）,而B组患者治疗后KPS评分显著高于A组（t＝2．78,P＜0．05）。 B组患者白细胞减少、血小板减少、恶心呕吐、腹泻及食欲减退发生率均显著低于A组,差异有统计学意义（χ2值分别为5．86、8．61、13．20、4．22、5．15,均P＜0．05）,而两组患者肝功能损伤发生率比较差异无统计学意义（χ2＝0．38,P＞0．05）。结论两种单药化疗联合盆腔三维适形放疗治疗Ⅱ～Ⅳ期宫颈癌临床疗效及生存率接近;但相较于铂类单药化疗,紫杉醇脂质体单药化疗联合盆腔三维适形放疗治疗Ⅱ～Ⅳ期宫颈癌可有效提高生活质量,降低不良反应发生风险。     

Psychological well-being among cancer patients receiving radiotherapy –a prospective study

The impact of cancer on the psychological well-being of newly diagnosed cancer patients before and during the course of radiotherapy was assessed in 70 consecutive cancer patients. Most of the patients were over 40 years of age, women, illiterate and from a lower socioeconomic group. During the course of treatment there was a decrease in the well-being scores on some dimensions such as perceived family and primary group support. Improvements were seen in the dimensions of positive feelings, coping, social support other than the family and spiritual well-being. There were no changes in the dimensions of negative feelings and perceived ill-health. The results give a profile on well-being and the changes observed during radiotherapy.     

Simple nutritional intervention in patients with advanced cancers of the gastrointestinal tract,non‐small cell lung cancers or mesothelioma and weight loss receiving chemotherapy: a randomised controlled trial

Background: Weight loss in patients with cancer is common and associated with a poorer survival and quality of life. Benefits from nutritional interventions are unclear. The present study assessed the effect of dietary advice and/or oral nutritional supplements on survival, nutritional endpoints and quality of life in patients with weight loss receiving palliative chemotherapy for gastrointestinal and non‐small cell lung cancers or mesothelioma. Methods: Participants were randomly assigned to receive no intervention, dietary advice, a nutritional supplement or dietary advice plus supplement before the start of chemotherapy. Patients were followed for 1 year. Survival, nutritional status and quality of life were assessed. Results: In total, 256 men and 102 women (median age, 66 years; range 24–88 years) with gastrointestinal (n = 277) and lung (n = 81) cancers were recruited. Median (range) follow‐up was 6 (0–49) months. One‐year survival was 38.6% (95% confidence interval 33.3–43.9). No differences in survival, weight or quality of life between groups were seen. Patients surviving beyond 26 weeks experienced significant weight gain from baseline to 12 weeks, although this was independent of nutritional intervention. Conclusions: Simple nutritional interventions did not improve clinical or nutritional outcomes or quality of life. Weight gain predicted a longer survival but occurred independently of nutritional intervention.     

紫杉醇在宫颈癌新辅助化疗中的应用

紫杉醇(泰素pac litaxel,商品名Taxol)是具有独特作用机制的广谱抗肿瘤药物,临床上以单药或与其它化疗药联合应用对多数实体瘤有效。对于局部晚期或复发的宫颈癌患者,紫杉醇可用于辅助化疗或作为放疗增敏剂。     

A multi-institutional survey of the quality of life after treatment for uterine cervical cancer: a comparison between radical radiotherapy and surgery in Japan

This study aimed to research the post-treatment quality of life (QOL) between radiotherapy (RT)- and operation (OP)-treated early cervical cancer survivors, using separate questionnaires for physicians and patients. We administered an observational questionnaire to patients aged 20–70 years old with Stages IB1–IIB cervical cancer who had undergone RT or OP and without recurrence as outpatients for ≥6 months after treatment. We divided 100 registered patients equally into two treatment groups (n = 50 each). The average age was 53 and 44 years in the RT and OP groups, respectively. The RT group included 34 and 66% Stage I and II patients, respectively, whereas the OP group included 66 and 34% Stage I and II patients, respectively. The OP group included 58% of patients with postoperative RT. Combination chemotherapy was performed in 84 and 48% of patients in the RT and OP groups, respectively. On the physicians’ questionnaire, we observed significant differences in bone marrow suppression (RT) and leg edema (OP). On the patients’ questionnaire, significantly more patients had dysuria and leg edema in the OP group than in the RT group, and severe (Score 4–5) leg edema was significantly higher in the post-operative RT group than in the OP only group. The frequency of sexual intercourse decreased after treatment in both groups. On the patients’ questionnaire, there were no significant differences between the two groups regarding sexual activity. These findings are useful to patients and physicians for shared decision-making in treatment choices. The guidance of everyday life and health information including sexual life after treatment is important.