首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 31 毫秒
1.
卡铂、表阿霉素为主联合动脉灌注对肺癌的近期疗效观察   总被引:1,自引:0,他引:1  
目的:探讨卡铂、表阿霉素在动脉中联合灌注治疗肺癌中的近期疗效分析。方法:46例中晚期肺癌术前均经病理诊断证实。鳞癌26例,腺癌13例,未分化小细胞肺癌7例,采用经皮股动脉穿刺插管,选择患侧支气管动脉开口处,进行动脉造影确诊后,再进行大剂量抗癌药物灌注及栓塞,间隔1个月后重复治疗一次,结果:按实体癌的疗效标准,动脉联合灌注治疗后,磷癌CR6例,PR24例,NR2例,腺癌CR2例,PR16例,NR2例,未分化小细胞癌CR1例,PR2例,NR1例,本组46例病人随访3年,生存期6个月以上5例,6-12个月16例,12-20个月15例,21-24个月8例,25-36个月7例,平均生存期为14.2个月。结论:支气管动脉联合大剂量灌注化疗药物,优于单纯动脉灌注效果,本文CBP加入Vp-16临床实验对小细胞肺癌有效率的89.2%,即可提高临床治疗效果,同时又能达到治疗目的。  相似文献   

2.
目的观察替吉奥单药治疗老年晚期胃癌的临床疗效和不良反应。方法将43例具有可测量病灶的老年晚期胃癌患者随机分为2组:替吉奥组(n=22)采用替吉奥胶囊单药治疗,对照组(n=21)采用FOLFOX4方案,经过2个周期的化疗后进行疗效评价。结果替吉奥组有效率为40.91%;对照组有效率为28.57%,2组有效率比较,差异无统计学意义。替吉奥组和对照组患者的中位无疾病进展时间及中位生存期分别为7.8个月、12.8个月与6.2个月、8.3个月。替吉奥组仅出现1例Ⅲ/Ⅳ级不良反应,而对照组有8例发生Ⅲ/Ⅳ级不良反应。恶心呕吐、腹泻、肢端麻木等不良反应的发生率替吉奥组也明显低于对照组。结论替吉奥单药治疗老年晚期胃癌疗效确切,毒副反应低,临床应用方便。  相似文献   

3.
Pancreatic cancer has a poor prognosis and, with the exception of surgery, no effective therapy is available for this devastating disease. Responsiveness to chemo- or radiotherapy is low. Viscum album preparations with known immunomodulating properties such as Iscador are used in anthroposophically orientated complementary medicine to treat tumor patients. However, the effect of mistletoe therapy on the survival of patients with cancer of the pancreas has not been investigated by controlled clinical studies. As a first step we did a retrospective analysis of survival for all patients with pancreatic cancer treated with Iscador at the Lukas Clinic Arlesheim, Switzerland, between 1986 and 1996. Iscador was given by subcutaneous injection two or three times a week, with doses ranging from 0.1 to 30 mg. Of a total of 320 patients, 292 had died by the end of the observation period and were available for statistical analysis. Patients' characteristics showed a prognostically unfavourable predominance of advanced stages of the disease. Median delay between diagnosis and admission for Iscador treatment was 5 weeks for stage IV cases, and 33 weeks for patients with operable tumors. One year survival rate was 26.3%. Median survival time was calculated for all stages. It was 6.58 months for the complete group, 16.69 months for 29 patients who had undergone resection, and 5.6 months for 161 stage IV cases. Viscum album treated patients had better results or at least survival times in the upper ranges compared with stage related survival reported in the literature. Taking into account the lack of beneficial treatment modalities for pancreatic cancer, research should be done prospectively in order to further evaluate this therapeutic approach.  相似文献   

4.
The aim of this study is to evaluate the results of treatment for hypopharyngeal cancer and indicate the future prospect of the treatment. Seventy-four patients with squamous cell carcinoma of the hypopharynx admitted to Miyagi Cancer Center from 1993 through 2000 are reviewed. Sixty-four patients received radical treatment, and 10 patients received palliative treatment or no treatment. The cancer was advanced (stages III and IV) in 82% of all the patients. The overall 5-year survival rate of all the patients was 38%. The overall 5-year survival rate of 64 patients received radical treatment was 43%. The ten patients who received palliative treatment or no treatment died of cancer within 16 months. Fifty-two out of the 74 patients underwent neck dissection for the neck lymph node involvement; forty of the 52 patients underwent ipsilateral neck dissection and 12 underwent bilateral neck dissection. Four out of the 40 patients, who underwent ipsilateral neck dissection alone, developed late contralateral regional recurrence but were successfully treated by contralateral neck dissection at the time of recurrence. Twenty-three out of 74 patients had multiple primary cancers synchronously or metachronously (31%). Cause of the death of six patients out of 74 patients was confirmed to be primary cancers other than hypopharyngeal cancer, as judged by physicians in other department or other hospitals. Most of the patients died due to distant metastasis from hypopharyngeal cancer or other primary cancers. We therefore conclude that contralateral elective neck dissection which is frequently chosen for the treatment of hypopharyngeal cancer surgery is unnecessary. Even if locoregional control is accomplished, distant metastasis or multiple primary cancers emerge and make prognosis poor. To improve the prognosis, we should develop some strategy against hypopharyngeal cancer for each patient. New strategies including chemoprevention and surgery against distant metasistasis are necessary.  相似文献   

5.
In recent years, patients with advanced cancer are referred more frequently to palliative care programs. However, the referrals usually occur relatively late for the management of severe physical and psychological distress. The purpose of this retrospective study was to investigate the interval between palliative care referral and death in patients with advanced cancer. We reviewed charts of 240 consecutive patients with advanced cancer referred to the palliative care program at M.D. Anderson Cancer Center between September and December 2003. Demographics, as well as dates of cancer diagnosis, advanced disease diagnosis, palliative care referral, and death were determined. The median age was 61 years old, 173 were male, 304 patients had solid tumors, and 26 had hematologic malignancies. The median time intervals between the diagnosis of the primary cancer and death, diagnosis of advanced disease and death, advanced disease and palliative care referral, and palliative care referral and death were 33.0 months (95% confidence interval [CI]: 25.8-41.9), 9.4 months (95% CI: 7.9-11.1), 5.6 months (95% CI: 4.3-7.7), and 1.9 months (95% CI: 1.6-2.2), respectively. The patients' median time interval from advanced cancer diagnosis to death and from palliative care referral to death was shorter in patients with hematologic malignancies than in those with sold tumors (p = 0.018 and p < 0.001, respectively). Median time interval between palliative care referral and death was longer for patients less than 65 year old than those 65 years old or more (p = 0.03). Our results should help palliative care and oncology programs at comprehensive cancer centers plan how to develop joint programs for patient care.  相似文献   

6.
There is always an interval between the first symptoms, time to diagnosis and start of treatment in women with symptomatic breast cancer. Delay may be due to the patient, her general practitioner or a false negative diagnosis in hospital. A systematic overview showed that delays of 3-6 months were clearly associated with increased tumour size, advance in disease stage and poorer long-term prognosis. Nevertheless, controversy persists regarding the impact of delay on survival. The conflicting results may be due to a difference in sample characteristics, differences in the delay interval studied or variations in the definition of delay. A major drawback of many studies was that the potential confounding effect of lead-time bias was not taken into account. One of the largest single institution studies, designed to control for the lead-time bias, confirmed that survival measured from both date of diagnosis and onset of patient's symptoms was worse in women with delays of >12 weeks. Within individual stages, longer delays had no adverse impact on survival. It is important to identify groups of patients at high risk of delay so that strategies can be developed and effectively targeted.  相似文献   

7.
目的评价自膨胀式带膜支架治疗晚期食管癌并发食管恶性狭窄或食管支气管瘘临床应用价值。方法对48例晚期食管癌在X线电视监视下置入自膨胀式带膜支架,其中食管恶性狭窄39例,食管气管(支气管)瘘9例。结果 48例中47例置入成功,1例下胸段食管癌因患有胃扭转置入支架失败。全部病例术后吞咽功能立即得到改善,并发食管—支气管瘘患者呛咳消失。全部病例术后出现胸痛、胸部异物感,症状多在1周内消失。1例术后出现呼吸困难,为左主支气管受压所致。8例于术后3~7个月发生再狭窄。本组47例术后平均生存期近7个月。结论自膨胀式带膜支架治疗晚期食管癌临床应用简单易行、安全可靠,有效提高生存期,临床应用前景广阔。  相似文献   

8.
Palliation of unresectable head and neck cancer remains a difficult problem. Because of excellent results reported by others with infusion of vinblastine, methotrexate, and 5-fluorouracil into the external carotid artery followed by irradiation before curative surgery, we applied this technic to 22 patients with advanced head and neck cancer. Fifteen patients from this group who had chemotherapy infusion followed by radiation therapy are compared with 21 patients who received radiation therapy alone. Both groups were similar in distribution of primary site, histology, and TNM stage. Of 15 patients, 14 (93%) had partial or complete tumor regression after both arterial chemotherapy infusion and irradiation, while 14 of 17 patients (82%) receiving primary irradiation had partial or complete response. Drug toxicity and complications related to infusion occurred in all patients. Most patients in both groups had short survivals (mean of 14.1 months in infusion chemotherapy and radiation vs 9.1 months in primary irradiation). One patient remains alive in the infusion group and two in the control group; however, all have recurrent disease. Results indicate a slight increase in survival time with the addition of infusionchemotherapy to irradiation in palliative treatment of head and heck cancer.  相似文献   

9.
Distant metastases from breast cancer are incurable. In endocrine-responsive patients antiestrogens are commonly administered as first and second line therapy. Regrettably, tumor growth becomes resistant to this relatively innocuous therapy. Beta-interferon was unsuccessfully added to tamoxifen to induce estrogen receptor enhancement. In mice, interleukin-2 added to tamoxifen increased their mutual anti-tumor activities. Nevertheless, no effective clinical application has been developed. We started an exploratory clinical trial based on the association of these immunostimulating cytokines with antiestrogens for first line salvage therapy of hormone dependent breast cancer with distant metastases. Twenty-six consecutive breast cancer patients with distant metastases, 23 of which had metastases at multiple sites, were studied for responsiveness to treatment with first line salvage antiestrogen therapy, combined with beta-interferon and interleukin-2 immuno-therapy. Clinical response and survival were compared with that of 30 consecutive historical control patients treated with antiestrogen therapy alone. Controls showed, as expected, a median duration of response, a median survival time after treatment, and after diagnosis of distant metastases, of 16, 31 and 34 months, respectively. After a mean follow-up of 62+/-36 months (range 17-155), the interval times in the non-control patients were 61 (P<0.001), 101 (P<0.000001) and 106 (P<0.000001) months. Two long-term survivors appeared to be cured after 155 and 94 months from the time of diagnosis with multiple bone metastases. Nineteen of the patients treated with beta-interferon and interleukin-2 have survived. Hormone immuno-therapy was given in an outpatient setting and was very well tolerated. These data suggest that immuno-therapy plays an important role in endocrine-dependent metastatic breast cancer.  相似文献   

10.
To date, pancreatic cancer (PDAC) can't be diagnosed early. Consequently, a majority of patient (80%) display an advanced disease that results in a low resection rate leading to an overall median survival of 4 to 6 months. Accordingly, robust markers for the early diagnosis and prognosis of pancreatic cancer, or markers indicative of survival and/or metastatic disease are desperately needed to help alleviate the dismal prognosis of this disease. In this chapter, we review the translational studies demonstrating that miRNAs, alone or in combination, may soon translate into clinical applications as long-awaited screening tools for PDAC.  相似文献   

11.
目的探讨贝伐珠单抗与雷替曲塞联合伊立替康或奥沙利铂在晚期结直肠癌二线以上治疗中的效果及安全性。方法 28例晚期结直肠癌患者,二线以上治疗应用贝伐珠单抗+雷替曲塞、或贝伐珠单抗+雷替曲塞+伊立替康、或贝伐珠单抗+雷替曲塞+奥沙利铂方案,均21d为1个周期,2个周期后评价疗效。结果 28例患者共完成76个周期化疗,均可评价疗效,其中部分缓解12例,稳定11例,进展5例,有效率为42.9%,疾病控制率为82.1%;中位无疾病进展时间为5.3个月(95%CI:3.7~6.8),中位总生存期为10.8个月(95%CI:9.3~14.6);常见不良反应有骨髓抑制、乏力、腹泻和腹痛、高血压等,Ⅲ~Ⅳ级不良反应以中性粒细胞减少(4例)、腹泻(3例)、乏力(3例)、高血压(2例)为主。结论贝伐珠单抗与雷替曲塞联合伊立替康或奥沙利铂方案用于晚期结直肠癌二线以上治疗可获得较高疾病控制率,不良反应可耐受。  相似文献   

12.
目的:通过对宫颈癌患者的临床资料及治疗方案的分析研究,探讨中药治疗是否可以延长宫颈癌患者的生存期。方法:回顾性分析2015年1月-2019年1月1日在辽宁中医药大学附属医院肿瘤科住院治疗并随访到的宫颈癌患者的临床资料。采用单因素及多因素分析分别对患者的确诊时年龄、首诊KPS评分(百分制)、手术、放化疗、中药治疗情况(包括口服中药汤剂时间+中成药治疗情况)等因素进行分析,观察中药治疗是否为宫颈癌患者的独立预后因素,再将患者分为早期(Ⅰ-ⅡA期)组,中期(ⅡB-Ⅲ期)组及晚期(Ⅳ期)组,进一步分析对于不同分期的患者,中药治疗是否可以影响其预后,最后观察中药治疗对Ⅰ-ⅡA期术后的患者及ⅡB-Ⅲ期放疗后的患者生存预后的影响。结果:共收集120例,其中早期患者(Ⅰ-ⅡA期)共60例,早期术后患者53例,中期(ⅡB-Ⅲ期)患者42例,中期放疗后的患者36例,晚期患者(Ⅳ期)18例。单因素及多因素分析显示:中药治疗情况为120例宫颈癌者的预后因素(P<0.05),其中对于ⅡB-Ⅲ期患者的生存预后有明显的影响意义(P<0.05)。结论:中药治疗在一定程度上可延长宫颈癌患者的生存期。  相似文献   

13.
14.
目的 分析157 例晚期非小细胞肺癌(NSCLC)的临床资料,探讨影响晚期NSCLC 疗效的相关因素.方法 用回顾性分析的方法,将2006 年1 月至2008 年1 月在大连医科大学附属第二医院肿瘤科就诊的晚期NSCLC 患者纳入研究,分析近期和远期疗效以及影响疗效的相关因素.步骤:(1)统计一线治疗(化疗和靶向)的疾病进展时间(TTP),以性别、龄、卡氏评分、病理类型作为变量,探讨各变量对近期疗效的影响;(2)入组患者以生存期(OS)分成3 组,A 组OS <12 个月,组12 个月<OS <24 个月,C 组OS >24 个月.分别以性别、年龄、卡氏评分、临床分期、病理类型、有无恶性胸腔积液、转移位数目、是否综合治疗为变量进行分层分析,探讨各变量对远期疗效的影响.结果 157 例患者,女53 例(33.8%),男104(66.2%);鳞癌46 例(29.3%),腺癌99 例(63.1%),其他病理类型12 例(7.6%);Ⅲb 期60 例(38.2%),Ⅳ期97(61.8%).一线化疗中位TTP 4 个月,一线靶向中位TTP 4 个月.中位OS 13 个月,12 个月生存率58.0%,24 个月生存25.5%.卡氏评分是一线化疗TTP 的影响因素,卡氏评分≥70 分的患者TTP 较长,而性别、年龄、病理类型变量均未能影TTP.一线靶向治疗和一线化疗的近期疗效相近.性别、年龄和卡氏评分均是远期疗效的影响因素,年轻、女性、卡氏评分≥70 分的患者12 个月生存率及24 个月生存率较老年、男性、卡氏评分<70 分的患者高.病理类型和转移部位数目对OS 的响无统计学意义;Ⅲb 期和Ⅳ期在OS 是否大于12 个月分组中有统计学意义;157 例患者中有无恶性腔积液对OS 的影响亦统计学意义.综合治疗优于单一治疗或不治疗.结论 (1)卡氏评分是一线化疗TTP 的影响因素;一线靶向治疗和化疗的期疗效相近;(2)性别、年龄、卡式评分是远期疗效的影响因素;(3)Ⅲb 期和Ⅳ期在OS 是否大于12 个月分组中有统计学义;(4)综合治疗优于单一治疗或不治疗.  相似文献   

15.
Lung cancer, a common malignancy in Taiwan, involves multiple factors, including genetics and environmental factors. The survival time is very short once cancer is diagnosed as being in advanced stage and surgically unresectable. Therefore, a good model of prediction of disease outcome is important for a treatment plan. We investigated the survival time in advanced lung cancer by using computer science from the genetic polymorphism of the p21 and p53 genes in conjunction with patients' general data. We studied 75 advanced and surgical unresectable lung cancer patients. The prediction of survival time was made by comparing real data obtained from follow-up periods with data generated by an artificial neural network (ANN). The most important input variable was the clinical staging of lung cancer patients. The second and third most important variables were pathological type and responsiveness to treatment, respectively. There were 25 neurons in the input layer, four neurons in the hidden layer-1, and one neuron in the output layer. The predicted accuracy was 86.2%. The average survival time was 12.44 +/- 7.95 months according to real data and 13.16 +/- 1.77 months based on the ANN results. ANN provides good prediction results when clinical parameters and genetic polymorphisms are considered in the model. It is possible to use computer science to integrate the genetic polymorphisms and clinical parameters in the prediction of disease outcome. Data mining provides a promising approach to the study of genetic markers for advanced lung cancer.  相似文献   

16.
Brown ML  Riley GF  Potosky AL  Etzioni RD 《Medical care》1999,37(12):1249-1259
OBJECTIVES: This study develops estimates of long-term, cancer-related treatment cost using a modeling approach and data from the SEER-Medicare linked database. The method is demonstrated for colorectal cancer. METHODS: Data on Medicare payments were obtained for colorectal cancer patients for the years 1990 to 1994 from the SEER-Medicare linked database. Claims payment data for control subjects were obtained for Medicare enrollees without cancer residing in the same areas as patients. Estimates of long-term cost (< or = 25 years following the date of diagnosis) were obtained by combining treatment/phase-specific cost estimates with estimates of long-term survival from SEER. Treatment phases were defined as initial care, terminal care, and continuing care. Cancer-related estimates for each phase were obtained by subtracting costs for control subjects from the observed costs for cancer patients, matching on age group, gender, and registry area. Estimates of long-term cost < or = 11 years obtained by this method were compared with 11-year estimates obtained by application of the Kaplan-Meier sample average (KMSA) method. RESULTS: The mean initial-phase cancer-related cost was approximately $18,000 but was higher among patients with more advanced cancer. The mean continuing-phase cancer-related cost was $1,500 per year and declined with increasing age, but was higher on an annual basis among persons with later stages of cancer and shorter survival time. The mean terminal-phase cancer-related cost was $15,000 and declined with both age at death and more advanced stage at diagnosis. After the phase-specific estimates were combined, the average long-term cancer-related cost was $33,700 ($31,300 at 3% discount rate) for colon cancer compared with $36,500 ($33,800 at 3% discount rate) for cancer of the rectum. This represented about half of the total long-term cost for Medicare enrollees diagnosed with this disease. Long-term cost was highest for Stage III cancer and lowest for in situ cancer. Eleven-year cancer-related costs estimated by the KMSA method were similar to estimates using the phase-based approach. CONCLUSIONS: This paper demonstrates that valid estimates of cancer-related long-term cost can be obtained from administrative claims data linked to incidence cancer registry data.  相似文献   

17.
目的 探讨原发性肺淋巴上皮瘤样癌的临床特征、治疗及预后。方法 回顾性分析2015年1月至2019年12月在复旦大学附属中山医院厦门医院及复旦大学附属中山医院诊治的39例原发性肺淋巴上皮瘤样癌患者的临床资料,并进行总结。结果 19例(48.7%)患者体检时发现肿瘤,症状无特异性。83.9%(26/31)患者程序性死亡配体1(PD-L1)阳性,97.2%(35/36)患者EB病毒编码的小RNA(Epstein-Barr virus encoded small RNA,EBER)阳性。基因检测发现1例合并ROS-1基因重排,未检测到EGFR基因突变及ALK基因重排。64.1%(25/39)患者进行手术治疗,无法手术的患者采取多学科综合诊治策略。中位随访33.7(23.4, 47.7)个月,中位生存时间未达到。4例患者死亡,其中1例合并ROS-1基因重排,生存期24.4个月;另3例生存期为49.7、25.3、69.7个月。相关性分析显示PD-L1表达情况不是生存时间的独立影响因素。结论 原发性肺淋巴上皮瘤样癌是一种罕见类型的肺恶性肿瘤,发生与EB病毒密切相关,PD-L1高表达,肺癌驱动基因突变...  相似文献   

18.
目的 探讨高强度聚焦超声(HIFU)联合吉西他滨治疗晚期胰腺癌的预后及其影响因素.方法 选择63例胰腺癌晚期患者,均采用HIFU联合吉西他滨化疗,评价其疗效,随访0.5年及1年的生存率,收集并分析影响生存率的因素.结果 63例患者经HIFC联合吉西他滨治疗后,完全缓解0例,部分缓解7例(11.11%),疾病稳定36例(57.14%),疾病进展19例(30.19%),总疾病控制率68.25%.随访期内患者总中位生存时间为6.9个月,0.5年和1年生存率分别为53.97%和9.52%.单因素和COX回归分析结果发现KPS评分与有无肝转移是影响生存率的重要危险因素.本组未发现明显严重不良反应.结论 HIFU联合吉西他滨化疗治疗晚期胰腺癌可相对延长生存时间,无严重不良反应,对KPS评分高与无肝转移患者可采取更积极的治疗态度.  相似文献   

19.
目的 研究DNA修复基因XRCC1单核苷酸多态性与晚期非小细胞肺癌(NSCLC)患者对顺铂或卡铂为主的方案化疗后生存期的关系。方法 经病理学确诊的晚期NSCLC患者135例,采用顺铂或卡铂为主的方案进行化疗。化疗前采集患者外周血,以聚合酶链反应-限制性长度片段分析(PCR—RFLP)方法进行XRCC1 Arg194Trp和XRCC1 Arg399Gln基因多态性的分型。比较不同基因型患者化疗后的中位生存时间(MST)和1、2年生存率。结果 中位随访12个月,135例患者的MST和1、2年生存率分别为12个月和48.1%、13.1%。携带XRCC1 399Arg/Arg的NSCLC患者化疗后MST和1、2年生存率分别为14.0个月和56.3%、20.8%;携带XRCC1 399Arg/Gin或Gin/Gln基因型的NSCLC患者化疗后MST和1、2年生存率分别为10.0个月和39.0%、7.6%,差异均有显著性(P〈0.05)。携带XRCC1 194Arg/Arg的NSCLC患者的MST和1、2年生存率分别为11.0个月和43、6%、13.2%;携带XRCC1 194Arg/Gln或Gln/Gln基因型的NSCLC患者MST和1、2年生存率分别为13.0个月和49.6%、11.3%,两组之间差异无显著性(P〉0.05)。结论 XRCC1 Arg399Gln基因多态性与晚期NSCLC患者铂类药物化疗后的生存期有关。XRCC1 Arg3 99Gln基因多态性可以在一定程度上判断晚期NSCLC患者铂类药物化疗后的预后。  相似文献   

20.
目的:探究中晚期食道癌应用食管覆膜支架置入和球囊扩张术治疗的临床应用价值。方法:对我院收治中晚期食道癌患者110例进行回顾性分析,治疗前本组病例均有病理活检,患者均为不能手术或拒绝手术的患者。所有患者术前均行X线检查,确定病变部位、狭窄长度及与周围组织关系,本组病例均有在术前或术后配合化疗或放射治疗的情况。对110例患者分组,30例患者置入覆膜支架,对30例患者进行球囊扩张,对50例患者不分先后做了食管覆膜支架置入术和球囊扩张术。以术后狭窄扩张效果、生存质量及相关并发症进行比较分析。结果:支架置入成功率100%,平均生存期12个月,食道球囊扩张均经1~3次扩张达到预期效果,成功率70%,生存率9个月,食管覆膜支架置入术联合球囊扩张术治疗中晚期食道癌,总有效率100%,生存期平均16个月。结论:食管覆膜支架置入术联合球囊扩张术,在治疗中晚期食管癌能相对延长患者生存时间、提高生存质量方面明显优于单纯食道食管覆膜支架置入术及单纯球囊扩张术,患者疗效更高,具有理想的临床价值。  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号