非小细胞肺癌的化疗进展

肺癌是全球范围内危害人类健康的最主要的恶性肿瘤之一,80%～85%是非小细胞肺癌,非小细胞肺癌患者一旦确诊80%以上属于晚期,失去了根治性手术的机会,需行以化疗为主的综合治疗。本研究拟就近年来非小细胞肺癌化疗的现状及进展进行阐述。     

益气活血中药联合化疗对非小细胞肺癌患者免疫功能的影响

目的 利用Meta分析研究益气活血法对化疗非小细胞肺癌淋巴细胞亚群的影响。方法 检索PubMed、Embase、Cochrane图书馆、中国知网(CNKI)、维普期刊资源整合服务平台(VIP)、中国生物医学数据库(CBM)、万方数据知识服务平台(Wanfang)数据库。筛选出对照组为常规静脉化疗,实验组为常规化疗加上益气活血方药治疗非小细胞肺癌的随机对照试验,通过对研究进行筛选和资料提取,应用Revman5.3软件对外周血淋巴细胞亚群CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺和NK等结局指标进行Meta分析。结果 共纳入11项RCT,纳入患者940例,其中试验组共472例,对照组468例,系统评价结果显示,对比常规静脉化疗,益气活血方药联合化疗治疗能显著改善非小细胞肺癌患者CD3⁺[MD=5.42,95%CI(0.85,10.00),P<0.05]、CD4⁺[MD=7.07,95%CI(5.88,8.72),P<0....     

联合化疗对老年非小细胞肺癌生活质量的影响

目的了解老年晚期非小细胞肺癌新铂类两药化疗期间生活质量变化。方法采用欧洲癌症研究与治疗组织(EORTC)生活质量核心问卷(QLQ-C30)和肺癌附加问卷(QLQ-LC13)，分析老年晚期非小细胞肺癌三代新药与铂类两药联合化疗前后生活质量。结果化疗前后，呼吸系统症状明显减轻，认知功能、总体QoL、情绪功能、社会功能等改善，乏力和躯体功能恶化。其余变化不大。结论新铂类两药化疗对老年晚期非小细胞肺癌可行、有效。     

消癌平注射液联合化疗对中晚期肺癌患者CD4＋CD25＋FOXP3＋调节型T细胞的影响

目的探讨消癌平注射液联合化疗对中晚期肺癌患者CD4＋CD25＋FOXP3＋调节型T细胞的影响。方法 71例Ⅲ～Ⅳ期非小细胞肺癌患者随机分为治疗组与对照组,治疗组36例采用化疗联合消癌平注射液;对照组35例单独采用化疗,两组化疗均采用GP方案。完成2周期后,通过流式细胞仪测定两组患者治疗前后外周血中CD4＋CD25＋FOXP3＋调节型T细胞比例。结果治疗后治疗组患者CD4＋FOXP3＋T细胞占CD4＋T细胞及CD4＋CD25＋T细胞的比例分别为（6.2±2.4）%和（27.6±6.0）%,而对照组分别为（8.2±0.5）%和（32.1±7.6）%,两组比较差异有统计学意义（P〈0.05）。CD4＋T细胞占总淋巴细胞的比例,治疗组较对照组明显提高（P〈0.05）。结论消癌平注射液是一种较为理想的免疫增强剂,联合化疗可明显改善非小细胞肺癌患者的细胞免疫功能。     

艾迪注射液联合化疗治疗非小细胞肺癌的临床观察

目的:对比观察艾迪注射液联合TP方案化疗与单用TP方案化疗治疗晚期非小细胞肺癌(NSCLC)的临床疗效、生活质量及毒副反应。方法:84例晚期非小细胞肺癌患者随机分为观察组及对照组,每组42例。观察组:紫杉醇175mg/m2+顺铂80mg/m2d1联用艾迪注射液80ml+5%GS 500ml。对照组:紫杉醇175mg/m2+顺铂80mg/m2。化疗2周期后评价疗效,化疗前及化疗2周期后评价生活质量,每周期评价不良反应。结果:观察组和对照组有效率分别为38.10%和30.95%,差异无统计学意义(P<0.05),疾病控制率分别80.95%和54.76%,差异具有统计学意义(P<0.05)。治疗后观察组生活质量改善效果明显优于对照组(P<0.05)。观察组的白细胞减少、恶心呕吐及肝功能损害三方面不良反应较对照组明显减轻(P<0.05)。结论:艾迪注射液联合TP方案化疗可以提高患者的疾病控制率,改善生活质量,减轻化疗相关毒副反应。     

热疗联合化疗与单纯化疗治疗非小细胞肺癌的疗效比较

目的：探讨热疗联合化疗治疗非小细胞肺癌（non—small cell lung carcinoma，NSCLC）的疗效。方法：2003年9月～2006年11月我院对52例NSCLC进行微波热疗联合NP方案化疗联合治疗（热疗联合化疗组），3个周期后评价疗效；并与2006年1～11月16例NSCLC单纯化疗（单纯化疗组）进行对比。结果：热疗联合化疗组近期疗效明显好于单纯化疗组，热疗联合化疗组总有效率（RR）为65．4％（34／52），显著高于单纯化疗组总有效率37．5％（6／16）（Z=-2．419．P=0．016）；热疗联合化疗组结束后疼痛明显改善，单纯化疗组无镇痛作用，差异具有高度统计意义（Z=-6．486，P=0．000）；2组的不良反应主要表现为恶心、粒细胞减少、血小板降低和肝功能异常，差异无显著性（P〉0．05）。结论：热疗联合化疗治疗NSCLC疗效优于单纯化疗治疗NSCLC。     

化疗联合射频消融毁损治疗晚期非小细胞肺癌的研究进展

射频消融（radiofrequency ablation,RFA）是近年来开展的治疗晚期或因各种原因不能手术的原发性和转移性肺癌的新技术,因其临床适应证广、并发症少、临床研究证实有效,已成为晚期非小细胞肺癌（non-small cell lung cancer,NSCLC）的重要微创治疗手段。现有证据表明,RFA联合化疗能提高晚期NSCLC患者的生存率、降低术后复发,为目前晚期NSCLC患者提供了一种新的治疗手段。     

深部热疗联合化疗治疗非小细胞肺癌的疗效分析

目的:探讨深部热疗联合化疗治疗非小细胞肺癌(non-small cell lung carcinoma,NSCLC)的疗效.方法:40例NSCLC进行TP方案化疗联合深部热疗治疗(联合组),4个周期后评价疗效;并与40例NSCLC单纯化疗(TP方案)进行对比(单纯组).结果:深部热疗联合化疗组近期疗效明显好于单纯化疗组,联合组总有效率(RR)为65.0％,显著高于单纯组总有效率42.5％(Z=-2.286,P＜0.05);联合组结束后疼痛明显改善,差异具有高度统计意义(Z=-5.749,P=0.000);2组的不良反应主要表现为恶心、粒细胞减少、血小板降低和肝功能异常,差异无显著性(P＞0.05).结论:深部热疗联合化疗治疗非小细胞肺癌疗效优于单纯化疗.     

人参养荣汤对小细胞肺癌化疗后骨髓抑制患者疗效的影响

目的:探讨人参养荣汤对小细胞肺癌化疗后骨髓抑制患者疗效的影响。方法:选取本院2019年5月—2020年12月收治的小细胞肺癌化疗后骨髓抑制患者120例,按照随机数字表法分为治疗组(60例)和对照组(60例),对照组给予西药治疗,治疗组在对照组基础上加用人参养荣汤治疗,比较两组患者免疫指标[肿瘤坏死因子-α(TNF-α)、可溶性白细胞介素-2受体(sIL-2R)]、卡氏量表(KPS)及健康调查简表(SF-36)评分、血清白蛋白水平、白细胞计数、中性粒细胞计数、血小板计数、毒副反应发生率及临床疗效。结果:与治疗前比较,治疗后,两组患者KPS评分、SF-36评分、TNF-α、血清白蛋白水平、白细胞计数、中性粒细胞计数、血小板计数均升高(P＜0.05),且治疗组高于对照组(P＜0.05);sIL-2R水平降低(P＜0.05),且治疗组低于对照组(P＜0.05)。治疗组毒副反应发生率为31.67%,对照组毒副反应发生率为73.33%,治疗组低于对照组(P＜0.05);治疗组总有效率(76.67%)高于对照组(50.00%)(P＜0.05)。结论:人参养荣汤用于小细胞肺癌化疗后骨髓抑制患者,能够改善患者免疫功能及临床症状,提高生活质量,降低毒副反应发生率,增强疗效。     

正念冥想训练应用于非小细胞肺癌辅助化疗患者的效果

目的探讨正念冥想训练应用于非小细胞肺癌(NSCLC)辅助化疗患者的效果。方法随机将新乡市中心医院2012-10-2019-10间收治的168例NSCLC患者分为2组,各84例。对照组采取常规护理,观察组于对照组基础上采取正念冥想训练。统计2组患者护理前后的抑郁(SDS)、焦虑(SAS)评分及护理满意度。结果干预1个月后观察组患者的SDS、SAS分值低于对照组,护理满意度高于对照组,差异均有统计学意义(P<0.05)。结论对NSCLC辅助化疗患者采取正念冥想训练干预,可有效缓解其负性情绪,患者对护理的满意度高。     

Preoperative chemotherapy for cStage III-pN0 patients with non-small cell lung cancer

Objectives: Survival benefits with preoperative chemotherapy for non-small cell lung cancer (NSCLC) remain controversial. Preoperative chemotherapy may act on micrometastasis but not lymph node metastasis. To clarify the role of induction chemotherapy for control of micrometastasis, we reviewed and compared 5-year follow-ups of clinical stage III but pathologically-proven node-negative NSCLC patients after complete resection with or without preoperative chemotherapy. Methods: We reviewed 148 consecutive patients who underwent anatomical lung resection and mediastinal nodal dissection for pathologically-proven node-negative NSCLC at our hospital between 1994 and 1999. Fifty-six patients were preoperatively diagnosed as stage III: 26 received platinum-based chemotherapy prior to surgery (PCT group) and 30 underwent surgery without any prior chemotherapy (PRS group). Results: The 5-year survival rate for clinical stage I/II and pathological node-negative patients was 74.9%; for clinical stage III, but for pathological node-negative patients it was 92.3% in the PCT and 63.3% in the PRS groups. The survival benefit of preoperative chemotherapy was significant for clinical stage III patients without node involvement. Conclusion: Preoperative chemotherapy may provide survival benefits for node-negative NSCLC patients.     

Multimodality therapy for small cell carcinoma of the lung —The role of surgical treatment

Reviewing the outcome of 70 cases of clinically localized small cell lung cancer (SCLC) treated with combined modality treatment, we attempted to define the role of resection in this disease. The survival rate for all cases was 37 per cent at 2 years and 23 per cent at 3 years with a median survival time (MST) of 14 months. For 25 resected cases the overall 5-year survival rate was 37 per cent with an MST of 26 months. According to clinical staging, 5-year survival was 64 per cent for stage I and 20 per cent for stage II. However, none of the stage III cases achieved long-term survival, of over 3 years. In 45 non-resected cases, the overall response rate was 84 per cent with a 44 per cent complete response. The overall survival rate was 27 per cent at 2 years and 14 per cent at 3 years with an MST of 11 months. The 20 cases who achieved complete response had an MST of 26 months with 51 per cent alive at 2 years and 19 per cent at 5 years. Thus, we consider that lung resection is definitely indicated in cases with stage I and probably stage II SCLC. For stage III, however, particularly in cases with N2 disease, resection seems to offer no special benefit in favor of survival compared to combination chemotherapy and radiotherapy.     

康艾配合化疗治疗晚期非小细胞肺癌10例临床观察

目的:探讨康艾注射液配合化疗药物治疗晚期非小细胞肺癌的临床疗效.方法:采用康艾注射液配合化疗药物治疗晚期非小细胞肺癌10例,在每个化疗用药期间,同时静点康艾注射液10天.对不能进行化疗的患者,单用康艾注射液,每个疗程20天,连用8～15个疗程.结果:康艾注射液配合化疗用药,患者的食欲、睡眠改善、周身不适减轻、肝功肾功、心脏反应较轻,白细胞及血小板下降得到改善,疼痛明显减轻.结论:康艾注射液配合化疗药物,有增强免疫功能、缓解疼痛、清热解毒、提升白细胞的作用,有扶正祛邪、不伤患者正气的作用,通过长期应用,提高了晚期非小细胞肺癌的生活质量、延长了生存期.     

紫杉醇加顺铂的新辅助化疗对提高ⅢA期非小细胞肺癌手术切除率的临床作用

目的探讨紫杉醇加顺铂(TP方案)的新辅助化疗对提高ⅢA期非小细胞肺癌(NSCLC)手术切除率的影响。方法46例ⅢA期NSCLC患者随机分为新辅助化疗组(23例)和单纯手术组(23例)。新辅助化疗的患者确诊后即接受2个周期全身化疗然后手术。单纯手术组患者确诊的直接手术治疗。结果新辅助化疗有效率为56.5%,化疗毒副作用较轻,患者可以耐受。新辅助化疗组的手术切除率为95.6%,根治切除率为60.8%,明显高于单纯手术组患者(P<0.05)。后者的手术切除率和根治性切除率分别为73.9%和30.4%。新辅助化疗并未增加手术并发症。结论新辅助化疗可明显提高ⅢA期NSCLC患者的手术切除率和根治切除率。     

Postoperative adjuvant chemotherapy for stage I non-small cell lung cancer

Objective: Surgery constitutes the mainstay of treatment in stage I non-small cell lung cancer (NSCLC). However, a significant fraction of patients after surgical resection die mainly due to systemic relapse. Nonetheless, the best adjuvant treatment to improve survival and decrease relapse rate remains as an ever controversial issue. Therefore, we conducted a randomized trial to determine whether postoperative adjuvant chemotherapy is beneficial in prolonging survival and decreasing recurrence in patients with completely resected stage I NSCLC. Methods: It was designed as a randomized, prospective two-armed study with surgery only (control group, 59 patients) versus surgery plus adjuvant MVP (mitomycin C, vinblastin and cisplatin) chemotherapy (study group, 59 patients). Results: Data for all the patients were complete. Twenty-four patients in the control group and nine patients in the study group experienced tumor recurrence during the follow-up. Neither histological type nor surgical extent correlated with recurrence. However, the addition of adjuvant MVP chemotherapy could decrease the rate of recurrence and the incidence of cancer-related death after surgery in the patients of stage I NSCLC (P<0.05). We followed up at least 5 years, and the duration of mean follow-up was 7.3 years. The rates of the loco-regional and distant metastases were 3.4 and 40.7% in the control group, and 3.4 and 11.9% in the study group, respectively. The 5- and 10-year survival rates were 74.6 and 56.3% in the control group, and 81.4 and 65.0% in the study group, respectively (P=0.19, log-rank test). The 5- and 10-year disease-free survival rates were 64.8 and 54.8% in the control group, and 88.8 and 76.8% in the study group, respectively (P=0.002, log-rank test). Conclusions: Our results suggest that the addition of adjuvant MVP chemotherapy may reduce the incidence of distant metastasis and prolong the disease-free survival of the patients with stage I NSCLC after surgery.     

Single primary lung cancer consisting of three cancer cell types (small cell carcinoma, adenocarcinoma, and squamous cell carcinoma) in which each had metastasized to different lymph nodes

We report a case of a 70-year-old male smoker with a single primary tumor 2.5 x 3.0 cm in size in the right lung lower lobe. A transbronchial lung biopsy revealed squamous cell carcinoma of the lung. We performed right lower lobectomy with lymph node dissection (ND2a). The resected specimen consisted of three different cell types; small cell carcinoma, adenocarcinoma and squamous cell carcinoma (in a ratio of 70: 20: 10). Each cancer cell types had metastasized to different lymph nodes. The final diagnosis was a combined small cell carcinoma in the lung. Combined small cell carcinoma is uncommon, but is nevertheless a well-described diagnostic category in lung cancers.     

八珍颗粒联合左旋维生素C面膜治疗女性黄褐斑疗效观察

目的:观察八珍颗粒联合左旋维生素C面膜治疗女性黄褐斑的临床疗效。方法:采用八珍颗粒口服,结合左旋维生素C面膜治疗本病,并设对照组,口服维生素C、E,外用氢醌乳膏对比,3个月后对其疗效进行比较。结果:治疗组总有效率85.1%,对照组为52.8%,两组疗效有显著性差异(P<0.05)。结论:八珍颗粒联合左旋维生素C面膜治疗女性黄褐斑临床疗效显著。     

健脾益气方配合治疗胃癌术后患者康复治疗中的临床观察

目的 研究健脾益气方在胃癌术后患者康复治疗中的效果。方法 选取临沂市中医医院普外一科2018年1月至2019年6月所收治的胃癌患者60例,随机分为两组各30例。对照组术后以常规营养支持治疗,观察组加用健脾益气方治疗,比较疗效。结果 观察组的治疗总有效率高于对照组,观察组的术后恢复时间短于对照组,治疗优良率为 93.33%,高于对照组的 76.67%,差异比较有统计学意义(P<0.05)。结论 胃癌术后患者采用健脾益气方治疗,能有效缓解患者的消化系统不良反应、促进胃肠功能恢复。