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1.
Objective: To compare the curative effectiveness of continuous transarterial infusion chemotherapy and systemic venous chemotherapy in treating patients with advanced pancreatic cancer, and to evaluate the value of selective continu-ous transarterial infusion chemotherapy in treating advanced pancreatic cancer. Methods: Of the 51 patients with advanced pancreatic cancer receiving chemotherapy with gemcitabine and 5-fluorouracil, 25 patients were treated with selective con-tinuous transarterial infusion chemotherapy, 26 were treated with systemic venous chemotherapy, and curative effective-ness was analyzed retrospectively. Curative effectiveness included tumor volume, clinical benefit response (CBR), acute and subacute toxic reactions of antitumor drugs, survival rate and median survival time. Results: The objective effective rate in transarterial group was 32.0% versus 23.1% in systemic group without any significant difference (P = 0.475). Clinical benefit rates in transarterial group and systemic group were 80.0% and 50.0% respectively (P = 0.025). The 6-, 9-and 12-month accumulated survival rates and median survival time in transarterial group were higher than those of the systemic group (P = 0.002), the differences were statistically significant. However, the adverse reactions between the two groups were not statistically significant. Conclusion: Compared with systemic chemotherapy, continuous transarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate and survival time of patients with advanced pancreatic cancer, it is safe and reliable, and the adverse reactions is less.  相似文献   

2.
Objective:To present patterns of practice and outcomes in the adjuvant treatment of intermediate-and high-risk endometrial cancer.Methods:Retrospective data on 224 women with intermediate-risk and high-risk endometrial cancer from 1999 to 2006 were reviewed.All patients underwent surgical staging.Patterns of adjuvant treatment,consisting of pelvic radiotherapy,chemotherapy,and radiotherapy plus chemotherapy,were assessed.The 3and 5-year disease-specific survival(DSS) rates were calculated using the Kaplan-Meier method.Results:The difference in 5-year DSS rate was statistically significant between adjuvant group and non-adjuvant group(80.65% vs.63.80%,P=0.040).In 110 high-risk patients who underwent adjuvant treatment,both 5-year DSS rate and recurrent rate were significantly different in combined radiotherapy and chemotherapy group compared with radiotherapy alone and chemotherapy alone groups(DSS rate,P=0.049;recurrent rate,P=0.047).In 83 intermediate-risk women who underwent adjuvant treatment,there was no significant difference in 5-year DSS rate and recurrence rate among the combined radiotherapy and chemotherapy,radiotherapy alone and chemotherapy alone groups(DSS rate,P=0.776;recurrent rate,P=0.937).Conclusions:Adjuvant radiotherapy plus chemotherapy is associated with a higher 5-year DSS rate and lower recurrence rate compared with radiotherapy alone and chemotherapy alone in high-risk endometrial cancer patients.Patients with intermediate-risk endometrial cancer may be not likely to benefit from adjuvant combined radiotherapy and chemotherapy.  相似文献   

3.
吉西他滨联合奥沙利铂治疗晚期胰腺癌30例   总被引:1,自引:0,他引:1  
Objective: To evaluate the activity and safety of combination chemotherapy with gemcitabine plus oxaliplatin (GEMOX regimen) in patients of advanced pancreatic carcinoma. Methods: 30 patients with advanced pancreatic cancer were enrolled into this study. All patients received gemcitabine 1000 mg/m2, given by 30-minute intravenous infusion, on days 1 and 8 of each 21-day cycle. Oxaliplatin 100 mg/m2 was administered as a 2 h infusion on day 1 of each 21 day. Clinical outcomes for patients treated with two cycles of chemotherapy were evaluated according to WHO criteria. Results: All 30 patients were eligible for effectiveness and safety analysis. Objective response rate was approximately 20.0%. Clinical benefit response (CBR) was a composite of assessment of pain, performance status and body weight. The pain relief rate, improve-ment rate of performance status and body weight were 53.3%, 46.7% and 36.7%, respectively. The main adverse effects were bone marrow depression, peripheral nerve toxicity and gastrointestinal reaction. There was no treatment-related death during the chemotherapy. Conclusion: The high response rate with low toxicity observed in this study suggests that GEMOX regimen may be an effective alternative curative treatment for patients with advanced pancreatic carcinoma and can be used more extensively in clinical practice.  相似文献   

4.
OBJECTIVE To evaluate the efficiency of surgery plus radiotherapy and chemotherapy versus radiotherapy plus chemotherapy in the treatment of older patients with stage I or II cervical carcinoma and to seek suitable treatment for such patients. METHODS The clinical data of 179 elderly women with stage la or lib cervical cancer were analyzed retrospectively. One hundred and thirty-four cases underwent radical hysterectomy followed by adjuvant radiotherapy and/or chemotherapy (Group 1). Forty-five cases underwent radiation therapy plus adjuvant chemotherapy (Group 2). RESULTS The 5-year survival rates in group 1 and group 2 were 78.3% and 49.1%(P=0.04), respectively. The incidence of complications in group1 was 47.0%. Three patients died of complications after radical hysterectomy. The incidence of complications in group 2 was 75.6%. CONCLUSION Elderly patients with stage I or II cervical carcinoma should receive an operation if possible. In addition they should receive adjuvant treatments according to their personal conditions, and be treated with appropriate adjuvant chemo-and/or radiotherapy.  相似文献   

5.
Objective To analyze the therapeutic efficacy and treatment related toxicities for patients with locally advanced cervical cancer treated with three-dimensional conformal radiotherapy (3DCRT) combined with concurrent chemotherapy. Methods From January 2007 to February 2008, 181 patients with stage ⅡA-ⅣA cervical cancer were retrospectively analyzed. All patients were treated with CT-based three-dimensional external beam and 192Ir intracavity radiotherapy combined with concurrent weekly cisplatin-based chemotherapy. The median age was 50 years (range, 32 to 82 years). The overall survival ( OS), disease-free survival (DFS) and local control (LC) rates were calcalated by Kaplan-Meier method and the difference was compared using Log-rank test. The treatment related toxicities were evaluated according to Radiotherapy Oncology Group (RTOG) criteria. Results With a median follow-up time of 34 months and following rate of 92. 2%, the 3-year OS, DFS and LC rates were 73.4%, 70. 4% and 91.3%,respectively. The 3-year OS rate was 66. 9% for patients with tumor diameter ≥4 cm and 86. 4% for those with tumor diameter <4 cm( χ2 =6. 29 ,P =0. 012). The incidences of grade 1 and grade 2 acute toxicities of the lower gastrointestinal tract and the genitourinary system were 40. 0% ,45.0% and 19. 9% ,4. 4%,retrospectively. There were no grade 3 or more acute toxicities. The incidence of grades 3 or 4 late toxicities of the lower gastrointestinal tract was 4. 9%. Conclusions CT-based three-dimensional external beam and 192Ir intracavity radiotherapy combined with concurrent chemotherapy can achieve good therapeutic effects for locally advanced cervical cancer. The acute and late toxicities are significantly reduced compared with historic controls as a result of incorporation of 3DCRT technique.  相似文献   

6.
Objective: To evaluate the clinical effects of concurrent and sequential therapy for middle and advanced stage non-small cell lung cancer (NSCLC) useing IMRT combined with NP regimen chemotherapy. Methods: Eighty patients with middle and advanced stage NSCLC were randomized into two groups. Forty patients were underwent sequential therapy and other 40 patients were underwent concurrent therapy. IMRT was used in radiotherapy and NP regimen of vinorelbine+cispatin (NP) was used in chemotherapy. Results: (1) The overall response (CR+PR) rate was 75% in concurrent group and 45% in sequential group (P〈0.05); (2) The treatment courses were 84 days and 140 days for concurrent group and sequential group respectively (P〈0.05); (3) One-year survival rate in concurrent group was 72.4% and 52.3% in sequential group respectively; (4) The toxic effects can be tolerable by all of patients. Conclusion: The concurrent chemo-radiotherapy has better overall response, one-year survival rate and shorter treatment course than the sequential chemo-radiotherapy, so it is a better method for the treatment of middle and advanced stage NSCLC, but the long term survival rate will be studied.  相似文献   

7.
Objective: To evaluate the clinical effect of transurethral resection of bladder tumor(TUR-BT) combined with internal iliac artery chemotherapy and intravesical instillation therapy for muscle invasive bladder cancer(MIBC).
Methods: From February 2007 to April 2014, 62 patients with MIBC were treated with TUR-BT combined with intravesical instillation therapy, with or without internal iliac artery chemotherapy, and the chemotherapy regimen is gemcitabine and cisplatin(GC). The bladder preservation and survival rate as well as cancer-specific survival(CSS) rate and overall survival(OS) rate of the two groups were compared.
Results: Sixty-two patients were followed-up for 26-102 months with an average of 58.4±3.1 months. Recurrence-free survival(RFS) at 2-year for TUR + GC group and TUR group were 77.8% and 53.8%, respectively. Bladder preserved rate(BPR) at 3-year for TUR + GC group and TUR group were 94.4% and 80.8%. CSS rate at 2-year for TUR + GC group and TUR group were 94.4% and 84.6%. The diseasefree survival(DFS) at 1-year for TUR + GC group and TUR group were 83.3% and 61.5%, and 77.8% and 53.8% for the 2nd year. OS at 2-year for TUR + GC group and TUR group were 88.9% and 92.3%.
Conclusions: TUR-BT and intravesical instillation therapy combined with internal iliac artery chemotherapy for MIBC had a better outcome at RFS, BPR and DFS than the treatment without internal iliac artery chemotherapy, and no difference in OS and CSS.  相似文献   

8.
Objective: To compare the 5-year survival rates and complications of internal and external irradiation therapy combined with operation in patients with Ⅱ-Ⅲ period of cervical cancer.Methods: 162 cervical cancer patients after the whole palace resection pelvic lymphadenectomy were divided into three groups, and then accepted radiotherapy.The first group with 91 cases was accepted internal and external irradiation therapy before operation; the second group with 37 cases was given internal irradiation therapy before operation; the third group with 34 cases was given routine postoperative radiotherapy.External irradiation used 60Co irradiation or a linear accelerator, to the whole basin, and the irradiation dose of "B" point in preoperative radiotherapy was 26-30 Gy, in postoperative radiotherapy was 46-50 Gy; intraluminal brachytherapy used 192lr,the dose of "A" point was 5-15 Gy.Results: The 5-year survival rate of preoperative combined radiotherapy group was 78.0%(71/91), preoperative intracavitary radiotherapy group 64.9% (24/37), and postoperative radiotherapy group 35.3% (12/34).Comparing the 5-year survival rates of the preoperative combined and postoperative irradiation groups, there was significant difference (P<0.05).The major complications were radioactive proctitis and cystitis, the complication incidences of three groups were 35.2% (32/91), 32.4% (12/37), 38.2% (13/34), respectively, and the differences were not statistically significant (P>0.05).Conclusion: The intraluminal brachytherapy plus external irradiation can significantly increase the 5-year survival rate of patients with Ⅱa-Ⅲa stages, and the incidence of complications was not significant difference.  相似文献   

9.
Despite recent improvements to current therapies and the emergence of novel agents to manage advanced non-small cell lung cancer(NSCLC),the patients′overall survival remains poor.Re-challenging with first-line chemotherapy upon relapse is common in the management of small cell lung cancer but is not well reported for advanced NSCLC.NSCLC relapse has been attributed to acquired drug resistance,but the repopulation of sensitive clones may also play a role,in which case re-challenge may be appropriate.Here,we report the results of re-challenge with gemcitabine plus carboplatin in 22 patients from a single institution who had previously received gemcitabine plus platinum in the first-line setting and had either partial response or a progression-free interval of longer than 6 months.In this retrospective study,the charts of patients who underwent second-line chemotherapy for NSCLC in our cancer center between January 2005 and April 2010 were reviewed.All the patients who received a combination of gemcitabine and carboplatin for re-challenge were included in the study.These patients were offered second-line treatment on confirmation of clear radiological disease progression.The overall response rate was 15%and disease control rate was 75%.The median survival time was 10.4 months,with 46%of patients alive at 1 year.These results suggest that re-challenge chemotherapy should be considered in selected patients with radiological partial response or a progression-free survival of longer than 6 months to the initial therapy.  相似文献   

10.
Objective: To assess the safety and clinical antiangiogenic effect of recombinant adenovirus-p53 (rAd-p53) combined with hyperthermia plus or not plus radiotherapy in advanced cancer. Methods: Expression of Vascular epithelial growth factor (VEGF) after intratumoral injection of rAd-p53 was assayed by immunohistochemistry (IHC) imaging. Forty-four patients with advanced cancer were enrolled into this clinical study. The patients were intratumorally injected with rAd-p53 (Gendicine) at a dose of 1×1012 vp once a week, with a total of 4-54 (mean 7.7) times. Total of 4-29 (mean 8.5) times of hyperthermia was given to the patients. Among the 44 patients, 30 patients were concurrently added with radiotherapy of a total dose 30-76 Gy/15-38 f/3-8 w (mean 58 Gy). Results: Before and after intratumoral injection of rAd-p53, the VEGF IHC positive cell scores were 2.80 and 1.50, respectively (P=0.031). The treatment of rAd-p53 combined with hyperthermia plus or not plus radiotherapy in advanced cancer achieved CR rate of 13.60% (6/44), and PR rate of 29.6% (13/44), and thus the effective rate was 43.2%. In addition to 6 patients with CR, 19 patients (19/38, 50.0%) had low density area (LDA) of more than 50% area on CT image within tumor indicating tumor tissue necrosis. Conclusions: Our data indicate that rAd-p53 inhibits VEGF expression and angiogenesis, and promotes tumor necrosis and shrinkage induced by hyperthermia plus or not plus radiotherapy in advanced cancer.  相似文献   

11.
目的评价经动脉灌注健择化疗结合三维适形放射治疗局部晚期胰腺癌的疗效。方法51例局部晚期胰腺癌患者,其中24例采用经动脉灌注健择化疗结合三维适形放射治疗(综合治疗组),27例单纯应用经动脉灌注健择化疗(对照组)。结果综合治疗组和对照组临床获益反应有效率分别为91.7%和74.1%,两者差异有统计学意义(P〈0.01);综合治疗组总有效率(CR+PR)为70.8%,对照组总有效率(CR+PR)为33.3%,两组差异有统计学意义(P〈0.01);综合治疗组和对照组的6、12和24个月生存率分别为83.3%、62.5%、37.5%和55.6%、33.3%、11.1%,两组差异均有统计学意义(P(0.05)。结论经动脉灌注健择联合三维适形放射治疗局部晚期胰腺癌,在提高生存率、延长生存期方面优于单纯经动脉灌注健择化疗。  相似文献   

12.
目的:比较吉西他滨联合适形放疗与吉西他滨联合顺铂对局部晚期胰腺癌的疗效。方法:前瞻性分析了2002年3月-2005年8月收治的56例局部晚期胰腺癌患者的疗效,其中26例采用吉西他滨联合适形放疗(放化组),30例采用吉西他滨联合顺铂(化疗组)。结果:可评估病例54例,放化组有效率(CR+PR)为68.O%,化疗组有效率(CR+PR)为37.9%,两组差异有统计学意义(P=0.0275)。放化组和化疗组的6月生存率分别为84.O%和62.1%(P=0.0728);12月生存率分别为64.O%和37.9%(P=0.0561)。两组差异无统计学意义。放化组和化疗组的临床获益率(CBR)分别为84.0%和69.0%,两者差异无统计学意义(P=0.1976)。放化组和化疗组的严重不良事件总发生率分别为36.0%和44.8%,无统计学差异(P=0.5103)。结论:在近期疗效方面,吉西他滨联合适形放疗的近期疗效优于吉西他滨联合顺铂;而远期生存率,吉西他滨联合适形放疗虽然显示出一定的优势,但无统计学意义,二者在CBR和严重不良事件发生率无明显差异。  相似文献   

13.
Objective: To compare the curative effectiveness of continuous transarterial infusion chemotherapy and systemic venous chemotherapy in treating patients with advanced pancreatic cancer, and to evaluate the value of selective continuous transarterial infusion chemotherapy in treating advanced pancreatic cancer. Methods: Of the 51 patients with advanced pancreatic cancer receiving chemotherapy with gemcitabine and 5-fluorouracil, 25 patients were treated with selective continuous transarterial infusion chemotherapy, 26 were treated with systemic venous chemotherapy, and curative effectiveness was analyzed retrospectively. Curative effectiveness included tumor volume, clinical benefit response (CBR), acute and subacute toxic reactions of antitumor drugs, survival rate and median survival time. Results: The objective effective rate in transarterial group was 32.0% versus 23.1% in systemic group without any significant difference (P = 0.475). Clinical benefit rates in transarterial group and systemic group were 80.0% and 50.0% respectively (P = 0.025). The 6-, 9- and 12-month accumulated survival rates and median survival time in transarterial group were higher than those of the systemic group (P = 0.002), the differences were statistically significant. However, the adverse reactions between the two groups were not statistically significant. Conclusion: Compared with systemic chemotherapy, continuous transarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate and survival time of patients with advanced pancreatic cancer, it is safe and reliable, and the adverse reactions is less.  相似文献   

14.
同步放化疗治疗晚期胰腺癌临床观察   总被引:1,自引:0,他引:1  
目的观察三维适形放疗(3-DCRT)联合吉西他滨同步化疗治疗晚期胰腺癌的疗效和毒副反应。方法 38例晚期胰腺癌患者采用3-DCRT,局部DT:50~56 Gy,20~25次;同时应用吉西他滨1 000mg.m-2,静脉滴注,d1,8,15,每28 d重复。结果 38例患者均可评价疗效,总有效率为76.32%,局部控制率为86.85%。6、12、24个月生存率分别为85.12%、65.21%和14.03%。毒副反应轻微,患者均能耐受。结论 3-DCRT联合吉西他滨同步化疗治疗晚期胰腺癌是安全、有效的。  相似文献   

15.
Purpose: Pancreatic carcinoma is one of the most malignant tumors of the alimentary system, with relativelyhigh incidence rates. The purpose of this study was to assess the efficacy and safety of two regimens for advancedpancreatic carcinoma: continuous transarterial infusion versus systemic venous chemotherapy with gemcitabineand 5-fluorouracil. Methods: Of the 48 patients with advanced pancreatic carcinoma receiving chemotherapy withgemcitabine and 5-fluorouracil, 24 received the selective transarterial infusion, and 24 the systemic chemotherapy.For the continuous transarterial infusion group (experimental group), all patients received gemcitabine 1000mg/m2,given by 30-minute transarterial infusion, on day 1 of a 4-week cycle for 2 cycles, and a dose of 600 mg/m2 5-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. For the systemic venous group (controlgroup), gemcitabine and 5-fluorouracil were infused through a peripheral vein, a dose of 1000 mg/m2 gemcitabinebeing administrated over 30 min on days 1 and 8 of a 4-week cycle for 2 cycles, and a dose of 600 mg/m25-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. The effectiveness and safety were evaluatedafter 2 cyclesaccording to WHO criteria. Results:The objective effective rate in transarterial group was 33.3%versus 25% in the systemic group, the difference not being significant (P=0.626). Clinical benefit rates(CBR) inthe transarterial and systemic groups were 83.3% and 58.3%, respectively (P=0.014). The means and mediansfor survival time in transarterial group were higher than those of the systemic group (P < 0.005). at the sametime, the adverse effects did not significantly differ between the two groups (P > 0.05). Conclusion: Continuoustransarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate andsurvival time of patients with advanced pancreatic carcinoma, compared with systemic venous chemotherapy.Since adverse effects were limited in the transarterial group, the regimen of continuous transarterial infusionchemotherapy can be used more extensively in clinical practice. A CT and MRI conventional sequence can beused for efficacy evaluation after chemotherapy in pancreatic carcinoma.  相似文献   

16.
选择性动脉插管持续灌注化疗治疗晚期胰腺癌的疗效分析   总被引:5,自引:1,他引:4  
Zhou JX  Hong GB  Xu LY  Xu LF  Chen YT  Jiang RJ  Luo JH 《癌症》2004,23(12):1677-1680
背景与目的:晚期胰腺癌化学治疗效果差。本研究目的是探讨选择性动脉插管持续灌注化疗治疗晚期胰腺癌的临床疗效与应用价值。方法:20例晚期胰腺癌经选择性动脉插管持续灌注化疗。采用Seldinger技术经股动脉插管留置导管12例,经左锁骨下动脉插管植入药盒导管系统8例。导管选择至肿瘤供血动脉持续灌注化疗药物。9例采用THP-ADM HCPT 5-FU/CF方案,11例采用GEM CBP 5-FU/CF方案,4天为一疗程。4~6周重复1次疗程。治疗后观察客观缓解率、临床受益疗效(CBR)和病人的生存时间。结果:客观缓解率10%(CR、PR各1例),临床受益疗效70.0%,6个月及9个月生存率分别为58.8%和39.2%,中位生存期8.8个月。无出现插管合并症。结论:选择性动脉插管持续灌注化疗治疗晚期胰腺癌安全可靠。临床受益疗效良好,可提高患者的生存质量和生存期。值得临床进一步观察研究。  相似文献   

17.
经动脉持续灌注化疗治疗中晚期胰腺癌的临床分析   总被引:9,自引:0,他引:9       下载免费PDF全文
 目的 比较经动脉持续灌注化疗和全身静脉化疗治疗中晚期胰腺癌的临床疗效,探讨选择性动脉持续灌注化疗的临床应用价值。方法 51例中晚期胰腺癌,其中25例采用经动脉持续灌注吉西他滨和5-Fu方案,26例采用经外周静脉灌注吉西他滨和5-Fu方案。应用世界卫生组织实体瘤疗效评定标准评价疗效,肿瘤体积测量采用MRI或CT。使用临床受益反应(CBR)对疼痛、体力状况及体重改变情况作出综合评价。采用WH0抗肿瘤药物急性与亚急性毒性分级标准对不良反应进行评价。结果 动脉灌注化疗组的有效率(32.0%)高于外周静脉化疗组(23.1%),但差异无显著性。动脉灌注化疗组的临床受益率(80.0%)高于外周静脉化疗组(50.0%),差异有显著性。6个月、9个月、1年的累积生存率和中位生存时间,动脉灌注化疗组高于外周静脉化疗组,差异有显著性。按WHO分级标准,两组患者不良反应之间无显著性的差异。结论 经动脉持续灌注吉西他滨和5-Fu较外周静脉灌注吉西他滨和5-Fu能提高中晚期胰腺癌的临床受益率和生存期,其方法安全可靠,且不良反应少。  相似文献   

18.
目的探讨动脉化疗联合三维适形放疗治疗局部晚期胰腺癌的疗效和安全性。方法 20例局部晚期胰腺癌采用吉西他滨(1 000 mg/m^2)区域性动脉灌注结合静脉化疗联合三维适形放疗治疗。放疗采用常规分割,1.8~2.0Gy/次,1次/天,5次/周,放疗剂量95%PTV45~50 Gy/25次。结果 20例患者全部完成治疗计划,原发灶完全缓解率为5.0%,部分缓解率为65.0%,总有效率为70.0%。临床获益率为80.0%。中位生存期为13个月,1、2年总生存率分别为56.2%、19.6%。1~2级白细胞下降发生率为80.0%,3级为20.0%;1~2级急性胃肠道反应发生率为90.0%,3级为5.0%。结论区域性动脉灌注化疗联合三维适形放疗是治疗局部晚期胰腺癌的1种有效方法。  相似文献   

19.
目的 探讨三维适形放疗(3DCRT)同步奥沙利铂联合吉西他滨化疗治疗局部晚期胰腺癌的疗效和毒副反应.方法 入组局部晚期胰腺癌30例均接受3DCRT,总剂量45.0~50.4 Gy,5~6周内完成.在放疗的同时接受化疗,放疗结束后继续化疗2~4个周期,方案为:奥沙利铂100mg/m2,静脉滴注,d1;吉西他滨1 000 ...  相似文献   

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