中晚期上颌窦鳞癌98例临床疗效分析

目的探讨中晚期上颌窦鳞癌的治疗方法。方法对98例中晚期上颌窦鳞癌(不包括入院时已出现远处转移病例)患者采用不同治疗方法(包括单纯手术、单纯放疗、术前放疗 手术)下的生存情况进行回顾性分析。结果单纯手术、单纯放疗、术前放疗 手术的患者5年生存率分别为25.00%、33.33%、62.50%。结论中晚期上颌窦鳞癌选择术前放疗 手术的治疗方案优于单纯手术或单纯放疗。     

肺鳞癌化放疗夹心治疗探讨

肺鳞癌化放疗夹心治疗探讨陈秀勇郑晓郭金水朱永红陈晓钟杜向慧浙江省肿瘤医院（杭州３１００２２）本院从１９９３年７月～１９９４年９月共收治中晚期肺鳞癌８０例，一组采用化、放疗夹心治疗，另一组为单纯放疗，临床观察一年，对即期与近期疗效报告如下：材料与方法一...     

92例晚期上颌窦鳞癌患者的临床疗效分析

背景与目的:晚期上颌窦鳞癌的治疗效果较差,其有效治疗方式目前也尚未有统一意见。本研究旨在探讨晚期上颌窦鳞癌的合理治疗方法。方法:回顾性分析中山大学肿瘤防治中心1978年1月至2001年12月间T3、T4期上颌窦鳞癌患者92例的临床资料,按治疗方式不同,分为单纯放疗组21例,单纯手术组8例,综合治疗组63例(其中手术结合放疗51例,化疗 放疗12例)。结果:单纯放疗组3年和5年生存率分别为19.0%、9.5%,单纯手术组3年和5年生存率分别为25.0%、12.5%,综合治疗组3年和5年生存率分别为46.0%、33.3%。单纯放疗组及单纯手术组分别与综合治疗组比较,其3年和5年生存率的差异均有统计学意义(P<0.05)。在综合治疗组中,术前放疗 手术患者3年和5年生存率分别为33.3%、23.8%,手术 术后放疗患者3年和5年生存率分别为52.9%、47.1%,术前放疗 手术 术后放疗患者3年和5年生存率分别为53.8%、30.8%,化疗 放疗患者3年和5年生存率分别为50.0%、33.3%,在综合治疗组中各不同治疗组合间的临床疗效比较,差异无统计学意义(P>0.05)。结论:晚期上颌窦鳞癌行单一治疗效果较差,行综合治疗效果较好。如何制定以手术为主,有机结合放疗、化疗的最佳治疗模式,还有待进一步探讨。     

中晚期上颌窦癌综合治疗效果评价

自1981年至1991年共收治中晚期上颌窦癌77例。采用单纯放疗以及放疗、手术、化疗综合治疗,综合治疗组5年生存率明显提高。本文就治疗效果及影响预后的相关因素分析报导如下：材料与方法一般资料：本组男52例,女25例,男：女一又08：1。年龄12～85岁,平均56岁。病理类型：全部病例均经病理证实,其中鳞癌57例占74％,腺癌6例,末分化癌2例,腺样囊性癌5例,其它7例。临床分期,按美国1983年AJC分期法分期’‘’,正期4例,皿期4O例,IV期33例。治疗方法：单纯放疗34例,计划性术前放疗10例,非计划性术前放疗6例,术后放疗18例,其中术后有肿瘤残存者11…     

PEF方案治疗中晚期食管癌20例疗效观察

食管癌诊断时绝大多数属中晚期 ,能根治性手术切除的病例不足 1/3,因此合理地应用综合治疗是提高中晚期患者生存率和生活质量的主要措施。化疗主要用于大量的中晚期食管癌以及术后或放疗后局部复发或远处转移患者 ,多以联合化疗为主。 PEF (DDP、VP1 6 、5 -Fu)方案为常用的方案之一 [1 ,2 ]。本院自1998年 2月 - 2 0 0 0年 3月年采用 PEF方案治疗 2 0例中晚期食管癌患者 ,现报告如下。1　材料与方法1.1　临床资料　 2 0例中晚期食管癌病例系我院肿瘤内科住院患者 ,均经细胞学或病理学确诊 ,其中鳞癌 18例、腺癌2例 ;年龄 41岁～ 6 5岁…     

食管腺鳞癌22例临床分析

目的 总结食管腺鳞癌的临床特点、诊断、治疗和预后.方法 回顾性分析经病理确诊和治疗的22例食管腺鳞癌患者临床资料,应用Kaplan-Meier法进行生存分析.结果 22例食管腺鳞癌患者的临床症状、影像学表现和内窥镜下所见与食管鳞状细胞癌(鳞癌)相似.19例患者术前内窥镜活检误诊为鳞癌.单纯手术治疗16例,手术+术后放疗3例,单纯放疗、序贯化放疗和同期化放疗各1例.本组总的1、3、5年生存率分别为67.6%、33.8%和18.1%,中位生存时间为24.5个月.结论 食管腺鳞癌少见,易误诊,宜采用以手术为主的综合治疗,预后评价不一.     

喉咽癌放射治疗24例临床分析

 目的 对24 例喉咽癌放射治疗作出临床分析。方法 本院自1975 年至1990 年共收治24 例喉咽癌,所有病例均为Ⅱ-Ⅳ期鳞癌。均行单纯放射治疗。结果 生存3 年以上的病例,原发灶总剂量均为65Gy-70Gy;总剂量小于65Gy 和大于70Gy 的14 例患者均于1 年左右死亡。结论 说明65Gy-70Gy 是喉咽癌单纯放疗的适宜根治剂量;总剂量超过70Gy ,不会提高局控率,反会缩短生存期。对于Ⅲ、Ⅳ期病例,尤其是伴有颈淋巴结转移者,单纯放疗的5 年生存率仅14 % ,明显比文献报道的综合治疗低,因此Ⅲ、Ⅳ期喉咽癌宜采用手术加放疗的综合治疗。     

108例扁桃体鳞癌治疗效果的回顾性分析

背景与目的:扁桃体鳞癌的治疗,是选择根治性放疗加外科挽救手术,还是计划性术前放疗加手术,目前尚无一致观点。在Ⅲ～Ⅳ期扁桃体鳞癌患者中,仅以肿瘤大小和淋巴结转移来判断预后显然不足。为此,本研究旨在总结我院扁桃体鳞癌的治疗效果,并探讨上述两种治疗方法的适应证及影响预后的因素。方法:回顾性总结1984年～2000年我院收治的108例扁桃体鳞癌患者的临床资料,其中根治性放疗加外科挽救手术83例(A组),计划性术前放疗加手术25例(B组)。总结两组的治疗效果及口腔功能损害情况,分析肿瘤的放疗反应与生存率的关系。结果:联合根治术导致不同程度的口腔功能损害,其发生率在A组为24.1%(20/83),在B组达88.0%(22/25)。A组患者的5年生存率为59.3%,B组为55.4%(P=0.706)。放疗后转移淋巴结消失及手术标本有重度放疗反应者,A、B两组的5年生存率分别为73.0%和76.9%(P>0.05)。结论:根治性放疗加挽救性手术使部分扁桃体鳞癌患者避免了联合根治术,在一定程度上保留了口腔功能。放疗后淋巴结的消失情况及组织放疗反应程度可以作为晚期扁桃体鳞癌的预后参考指标。     

宫颈鳞癌单纯放疗与术后补救性放疗的对比观察

宫颈鳞癌单纯放疗与术后补救性放疗的对比观察刘凌宫颈癌的治疗以放射治疗与手术治疗为主要手段，宫颈鳞癌单纯放疗的疗效已得到国内外学者的肯定。我们将１９８７年１月～１９８８年１２月收治的１８０例宫颈鳞癌采用两种不同治疗方法进行了回顾性对比总结。１临床资料１...     

小柴胡汤合并放疗与单纯放射治疗食管鳞癌66例随机分组研究

对 6 6例中晚期食管鳞癌采用小柴胡汤合并放疗与单纯放疗前瞻性随机分组研究。综合治疗组的Ⅰ、Ⅱ级放射反应率分别为 4 2 .4 %、4 5 .4 % ,显著高于单纯放疗组的Ⅰ、Ⅱ级放射反应率。综合治疗组的 1 ,3年生存率显著高于单纯放疗组的 1 ,3年生存率 (P <0 .0 5 )。显示小柴胡汤合并放疗能提高中晚期食管癌放疗疗效及减轻食管癌放疗所致血象下降的毒性反应。     

扁桃体癌不同治疗方法的疗效对比分析

目的：分析与探讨扁桃体癌不同的治疗方案与疗效的关系。方法：１９８７年１０月￣１９９５年１２月间收治了９５例扁桃体癌,均经病理证实。８例采用联合根治术加化疗,９例为联合根治术前术后放疗,６２例单纯根治性放疗,１６例用根治性放疗加化疗。结果：本组１年、３年和５年生存率分别为８６．３２％,６２．９３％和５６．２６％。８例手术加化疗的患仅１例存活５年,四种治疗情况对其５年生存率和局部控制率的影响具有显     

Squamous Cell Carcinoma of the Tonsillar Region A Retrospective Analysis of Treatment Results

Seventy-five patients treated for squamous cell carcinoma of the tonsillar region during 1958-1982 were reviewed retrospectively. of the 75 patients, 30 received combined treatment with surgery and postoperative radiotherapy, and 45 radical radiotherapy alone. the 5-year survival rate for the entire patient series was 39%, the corresponding figure was 53% for the patients treated with combined therapy and 29% for the patients with radical radiotherapy. the radical radiotherapy group included more patients with advanced stage of the disease (stage III 27% and stage IV 66%) than the combined therapy group (47% and 23% respectively). Thirty-four patients (45%) died from uncontrolled disease.     

The benefits and pitfalls of ipsilateral radiotherapy in carcinoma of the tonsillar region

PURPOSE: Ipsilateral techniques designed to restrict treatment to the primary tumor and neck on the same side have been used in selected cases of cases of carcinoma of the tonsillar region at our institution for many years. The primary purpose of this study is to evaluate the risk of failure in the opposite neck in cases selected for unilateral radiotherapy over a 21-year period. METHODS AND MATERIALS: Ipsilateral radiotherapy techniques were used in 228 of 642 patients with carcinoma of the tonsillar region from 1970 to 1991. Local control, regional lymph-node control (including contralateral failure), and survival were calculated for different degrees of tumor extent treated with these techniques. RESULTS: Mean follow-up was 7 years. Cases tended to be T1 and T2, with N0 disease. The 3-year actuarial local control rate was 77% and cause-specific survival was 76%. Opposite neck failure was seen in 8 patients (crude rate of 3.5%). In the earlier period of the study, primary coverage was problematic in a proportion of cases and resulted in higher rates of local failure. CONCLUSION: Appropriately selected cases of carcinoma of the tonsil show minimal risk of failure in the opposite neck with ipsilateral techniques. Patients should undergo computed tomography planning to ensure adequate target coverage.     

放疗后宫颈癌根治术中输尿管梗阻的处理

目的　探讨经术前放疗后宫颈癌根治术中输尿管梗阻的处理。方法　 1978年 5月～ 1996年 6月 ,我院对171例中晚期宫颈癌 (行放疗、手术治疗 171例 )术前放疗后行宫颈癌根治术 ,术中发现输尿管梗阻 3 2例 ,占 18.7% ,双侧 9例、左侧 16例、右侧 7例。手术行子宫广泛切除术加盆腔淋巴结清扫术 ,同时对输尿管的梗阻进行手术处理 ,现对其进行回顾性分析总结。结果　手术 3 1例 ,放弃手术 1例 ,其中松解输尿管与周围组织粘连 2 7例 ,切除压迫输尿管转移淋巴结 2例 ,因癌性浸润输尿管而行部分输尿管切除 ,输尿管端端吻合术及输尿管膀胱吻合术各 1例。术后 2周输尿管引流通畅 ,肾功能明显好转 2 9例。经随访 ,2例患者 1年后因肾功能衰竭死亡 ,5年生存率为 48.3 9%。结论　中晚期宫颈癌放疗后出现输尿管梗阻 ,可考虑手术处理 ,可预防肾功能衰竭 ,能有效的提高患者的生存率     

Survival in patients with human papillomavirus positive tonsillar cancer in relation to treatment

The incidence of tonsillar cancer and the proportion of human papillomavirus (HPV) positive tonsillar cancer cases have increased in the last decades. In parallel, treatment for tonsillar cancer has been intensified e.g., by accelerated radiotherapy, and chemotherapy, resulting in more side effects. Patients with HPV-positive tonsillar cancer have better prognosis than those with HPV-negative tumors, and the former group could hypothetically benefit from reduced, less-toxic treatment without compromising survival. Here, we therefore evaluated possible differences in overall and disease-specific survival after different oncological treatments in 153 patients with HPV DNA- and P16-positive tonsillar cancer who were diagnosed and treated with intent to cure between 2000 and 2007, in Stockholm, Sweden. Of these patients, 86 were treated with conventional radiotherapy, 40 were treated with accelerated radiotherapy and 27 were treated with chemoradiotherapy. There were no significant differences in overall or disease-free survival between the groups. However, there was a trend, implying a beneficial effect of the intensified treatment, with chemoradiotherapy being better than radiotherapy despite that more patients had stage IV disease in the former group; and accelerated radiotherapy being better than conventional radiotherapy. This needs to be followed further in larger more homogenous groups of patients. In conclusion, patients with HPV-positive tonsillar cancer treated with conventional- or accelerated radiotherapy or chemoradiotherapy disclosed similar survival rates. The trend for better survival and less metastasis after intensified treatment underlines the need for large prospective studies comparing less intense to more intense treatment (chemoradiotherapy).     

127例原发齿龈鳞状细胞癌预后分析

目的: 探讨原发齿龈鳞状细胞癌最佳治疗方法及影响预后的因素. 方法: 分析我院1978年1月至1998年12月收治的127例原发齿龈鳞状细胞癌患者,观察其临床疗效. 结果: 127例中单纯手术18例,单纯放疗37例,术后放疗9例,术前放疗22例,化疗加手术31例,姑息化疗10例;5年生存率分别为27.5%、20.4%、66.7%、72.7%、50.2%和0. 结论: 齿龈鳞状细胞癌首选手术治疗,放疗和(或)化疗,是预防单纯手术后复发或放疗后局部未控的有效方法.综合治疗可以提高齿龈鳞状细胞癌的预后;影响预后的主要因素有治疗方法、分期、淋巴结转移和发病部位等.     

A STUDY OF ENDOSCOPIC TREATMENT OF ADVANCED ESOPHAGEAL AND GASTRIC CARCINOMA

Ｔｈｅｌｉｆｅｑｕａｌｉｔｙｏｆｇａｓｔｒｉｃａｎｄｅｓｏｐｈａｇｅａｌｃａｎｃｅｒｐａｔｉｅｎｔｓｗｅｒｅｖｅｒｙｐｏｏｒｗｈｅｎｔｈｅｒｅｗｅｒｅｒｅｃｕｒｅｎｃｅｌｅｓｉｏｎａｆｔｅｒｏｐｅｒａｔｉｏｎａｎｄｒａｄｉｏｔｈｅｒａｐｙ，ｅｓｐｅｃ...     

皮肤神经内分泌癌的治疗（附2例报告）

目的:探讨原发皮肤神经内分泌癌的治疗.方法:报告1995年和1998年收治的2例不同部位的皮肤神经内分泌癌,并复习文献资料.结果:1例手术 放疗,患者无病生存至今45个月;另1例手术 干扰素治疗,术后5个月出现区域淋巴结转移.结论:原发皮肤神经内分泌癌的治疗应以广泛手术加放疗为主.对进展期及晚期病人宜给予手术,化疗及放疗等综合治疗,辅助生物治疗也能改善患者生存质量.     

160例扁桃体癌的放射治疗及预后

目的：回顾性分析放射治疗扁桃体癌的疗效及预后因素,方法：160例经病理证实的扁桃体癌均行单纯根治性放射治疗。根据1997年国际抗癌联盟分期标准,Ⅰ期7例,Ⅱ期29例,Ⅲ期43例,Ⅳ期81例,生存分别采用Kaplan-Mcier法及Logrank检验,多因素分析采用Cox回归模型。结果：全组5、10年总生存率分别为59．2％、52．1％,5、10年无瘤生存率分别为59．0％、56．3％,Ⅰ-Ⅳ期5年生存率分别为83．3％、83．7％、73．5％和40．7％,多因素分析显示T、N分期为主要的预后因素。结论：单纯放射治疗扁桃特别是对Ⅰ、Ⅱ期病变可取得较好的疗效,T、N分期为主要的预后因素。     

Current management of tonsillar cancer

Traditionally, risk factors for the development of tonsil cancer include the use of alcohol and/or tobacco, however a significant proportion of new cases develop in young patients without these risk factors. Recent investigation suggests that human papilloma virus (HPV) may serve as an etiology in such cases and represent a unique risk factor in a sub-set of patients. Irrespective of the etiology, in the majority of cases early carcinoma of the tonsil can effectively be treated using single modality therapy. While local-regional control and survival are similar following surgery or radiotherapy, primary surgery can be accomplished with minimal functional morbidity while reserving radiation for recurrent disease. In contrast, surgical salvage following external beam radiotherapy can be technically challenging and is often associated with a significant increase in surgical complications and functional morbidity. In contrast to early tonsillar disease, advanced tonsil cancer represents a clinical challenge that requires multimodality therapy. While advanced lesions are often treated with a combination of radiation, chemotherapy, and surgical ablation, management of the neck and distant metastases continues to present a therapeutic dilemma.