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1.
目的 观察三维适形放疗(3D-CRT)联合吉西他滨及表阿霉素(GE)治疗晚期膀胱癌的临床疗效及不良反应.方法 将62例老年晚期膀胱癌患者随机分为两组,观察组(32例)采用放化疗,对照组(30例)单用化疗;两组均先用GE方案诱导化疗1个周期,间隔3 w后观察组加同步放化疗,放射治疗结束1个月后,比较两组近期疗效及不良反应;然后继续用GE方案化疗2~4个周期;随访2年评价远期疗效和生存率.结果 观察组有效率75.0%,对照组46.7%,两组比较有统计学差异(P<0.05).观察组Karnofsky计分提高+稳定者占78.1%(25/32),高于对照组53.3%(16/30),两组比较有显著性差异(P<0.05).观察组白细胞下降、血小板减少、恶心呕吐、肝肾功能异常等不良反应发生率稍高于对照组,但比较无显著性差异(P>0.05).两组2年生存率比较无统计学差异(P>0.05).结论 3D-CRT联合吉西他滨及表阿霉素治疗老年晚期膀胱癌能改善患者的生活质量,提高患者的近期疗效,不能明显提高患者的远期疗效. 相似文献
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目的 观察三维适形放疗(3D—CRT)、同步化疗加羟基喜树碱热灌注化疗治疗晚期膀胱癌的临床疗效及不良反应。方法将37例晚期膀胱癌患者随机分为两组,均采用3D—CRT加GC方案(吉西他滨+顺铂)化疗,观察组加用羟基喜树碱热灌注化疗。放射治疗结束1个月后,比较两组近期疗效及不良反应;随访2a,评价远期疗效和生存率。结果观察组有效率高于对照组(P〈0.05)。观察组白细胞下降、血小板减少、恶心呕吐、肝功能异常等不良反应发生率稍高于对照组,但无统计学差异(P〉0.05)。两组2a生存率比较无统计学差异(P〉0.05)。结论3D—CRT、同步化疗加羟基喜树碱热灌注化疗治疗晚期膀胱癌疗效较好,可明显提高近期疗效,不良反应稍有增加,但患者能耐受,未能提高患者的生存率。 相似文献
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目的观察全身化疗加吡柔比星热灌注化疗治疗晚期膀胱癌患者的疗效及护理干预对生存质量的影响。方法 46例晚期膀胱癌患者采用GC方案,同时加用吡柔比星热灌注化疗。将患者随机分为观察组、对照组各23例,对照组患者住院期间及出院后给予常规的医护指导,而观察组同时给予心理护理及健康教育,两组患者均追踪随访2年。对两组患者临床疗效、生存期、不良反应及生存质量改善情况进行比较。结果观察组Karnofsky计分提高+稳定者占65.2%(15/23),高于对照组17.4%(4/23),差异有统计学意义。两组生活质量比较,观察组显著高于对照组(P<0.05);两组不良反应比较,差异没有统计学意义;两组2年生存率比较无统计学差异(χ2=1.134,P>0.05)。结论全身加吡柔比星热灌注化疗治疗晚期膀胱癌加护理干预可显著改善患者的生存质量。 相似文献
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目的 观察后程三维适形放疗(3D-CRT)联合紫杉醇同步化疗治疗老年乳腺癌伴脑转移癌患者的疗效及不良反应.方法 50例患者随机分为观察组(放疗加化疗组,26例)和对照组(单纯放疗组,24例).两组前程全脑均行普通二维放疗,在全脑照射总剂量(DT)30~40 Gy后,后程缩野对脑转移癌局部病灶行3D-CRT,每次2 Gy,每周5次,加量DT 10~24 Gy,至DT 50~64Gy.观察组在放疗2~4周期间给予紫杉醇65~85 mg/m2,静脉滴注第1、8天,同步化疗,然后继续用紫杉醇单药化疗2~4个周期(紫杉醇65~85 mg/m2,第1、8、15天静脉滴注);28 d为1周期,治疗2月后,观察两组近期疗效、不良反应及评价生活质量;随访2年评价客观疗效和生存率.结果 观察组有效率76.9%,高于对照组45.8%,两组比较有统计学差异(x2=5.120,P<0.05).Karnofsky计分提高+稳定者观察组80.8%、对照组54.2%,观察组生活质量改善高于对照组(x2=4.059,P<0.05);与对照组相比,观察组白细胞下降,差异有统计学意义;血小板减少、恶心呕吐、肝功能异常等不良反应发生率稍高于对照组,差异无统计学意义.两组2年生存率比较差异有统计学意义(x2=4.7260,P<0.05).结论 后程3D-CRT联合紫杉醇单药化疗治疗老年乳腺癌伴脑转移癌患者可提高远、近期疗效,不良反应虽有所增加,但患者能耐受,值得临床上进一步推广应用.Abstract: Objective To evaluate the efficacy and adverse reaction of three-dimensional conformal radiation therapy (3D-CRT) combined with chemotherapy of paclitaxel in treatment of brain metastases from breast cancer in the elderly.Methods The 50 patients were randomly divided into observation group (n=26,radiation combined with chemotherapy) and control group (n= 24,simple radiation).In the early stage,both groups received common two-dimesional conformal radiation therapy.The total dose (DT) of whole brain irradiation was 30-40 Gy.In the later stage,the reduced field for the local lesion of brain metastases would be altered to 3D-CRT for the post period with 2 Gy 5 times a week.DT was added from 10-24 Gy up to total DT of 50-64 Gy.The patients were given paclitaxel 65-85 mg/m2 by intravenous drip at 1st and 8th day with synchronization of 2-4 weeks,having paclitaxel chemotherapy of 2-4 circle,28 days a circle.After 2 month treatment,the efficacy and adverse effects of the two groups were observed.follow up for 2 years,the long-term efficacy and survival rate were evaluated.Results The effective rate was 76.9% in observation group and 45.8% in control group,respectively (x2 =5.120,P<0.05) and the KPS score was 80.8% and 54.2%,respectively.The quality of life was improved in observation group versus control group (x2 =4.059,P<0.05).Compared with control group,hypoleukemia was significant in observation group (P<0.05).The complications such as nausea and vomiting,hepatic dysfunction were more in observation group than in control group,but there was no statistical significance between two groups.There was statistic ally significant difference in 2-year survival rate between two groups (x2= 4.7260,P<0.05).Conclusions The 3D-CRT combined with paclitaxel chemotherapy is a prefered choice for locally advanced brain metastases from breast cancer.More side effects and adverse reaction are observed in observation group.However,all the patients could tolerate them.It is worthy of popularization and application. 相似文献
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Objective To evaluate the efficacy and adverse reaction of three-dimensional conformal radiation therapy (3D-CRT) combined with chemotherapy of paclitaxel in treatment of brain metastases from breast cancer in the elderly.Methods The 50 patients were randomly divided into observation group (n=26,radiation combined with chemotherapy) and control group (n= 24,simple radiation).In the early stage,both groups received common two-dimesional conformal radiation therapy.The total dose (DT) of whole brain irradiation was 30-40 Gy.In the later stage,the reduced field for the local lesion of brain metastases would be altered to 3D-CRT for the post period with 2 Gy 5 times a week.DT was added from 10-24 Gy up to total DT of 50-64 Gy.The patients were given paclitaxel 65-85 mg/m2 by intravenous drip at 1st and 8th day with synchronization of 2-4 weeks,having paclitaxel chemotherapy of 2-4 circle,28 days a circle.After 2 month treatment,the efficacy and adverse effects of the two groups were observed.follow up for 2 years,the long-term efficacy and survival rate were evaluated.Results The effective rate was 76.9% in observation group and 45.8% in control group,respectively (x2 =5.120,P<0.05) and the KPS score was 80.8% and 54.2%,respectively.The quality of life was improved in observation group versus control group (x2 =4.059,P<0.05).Compared with control group,hypoleukemia was significant in observation group (P<0.05).The complications such as nausea and vomiting,hepatic dysfunction were more in observation group than in control group,but there was no statistical significance between two groups.There was statistic ally significant difference in 2-year survival rate between two groups (x2= 4.7260,P<0.05).Conclusions The 3D-CRT combined with paclitaxel chemotherapy is a prefered choice for locally advanced brain metastases from breast cancer.More side effects and adverse reaction are observed in observation group.However,all the patients could tolerate them.It is worthy of popularization and application. 相似文献
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Objective To evaluate the efficacy and adverse reaction of three-dimensional conformal radiation therapy (3D-CRT) combined with chemotherapy of paclitaxel in treatment of brain metastases from breast cancer in the elderly.Methods The 50 patients were randomly divided into observation group (n=26,radiation combined with chemotherapy) and control group (n= 24,simple radiation).In the early stage,both groups received common two-dimesional conformal radiation therapy.The total dose (DT) of whole brain irradiation was 30-40 Gy.In the later stage,the reduced field for the local lesion of brain metastases would be altered to 3D-CRT for the post period with 2 Gy 5 times a week.DT was added from 10-24 Gy up to total DT of 50-64 Gy.The patients were given paclitaxel 65-85 mg/m2 by intravenous drip at 1st and 8th day with synchronization of 2-4 weeks,having paclitaxel chemotherapy of 2-4 circle,28 days a circle.After 2 month treatment,the efficacy and adverse effects of the two groups were observed.follow up for 2 years,the long-term efficacy and survival rate were evaluated.Results The effective rate was 76.9% in observation group and 45.8% in control group,respectively (x2 =5.120,P<0.05) and the KPS score was 80.8% and 54.2%,respectively.The quality of life was improved in observation group versus control group (x2 =4.059,P<0.05).Compared with control group,hypoleukemia was significant in observation group (P<0.05).The complications such as nausea and vomiting,hepatic dysfunction were more in observation group than in control group,but there was no statistical significance between two groups.There was statistic ally significant difference in 2-year survival rate between two groups (x2= 4.7260,P<0.05).Conclusions The 3D-CRT combined with paclitaxel chemotherapy is a prefered choice for locally advanced brain metastases from breast cancer.More side effects and adverse reaction are observed in observation group.However,all the patients could tolerate them.It is worthy of popularization and application. 相似文献
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老年人晚期肺癌热灌注化疗的初步经验 总被引:1,自引:0,他引:1
1995年 5月至 1998年 2月 ,我们采用单侧肺隔离体外循环机辅助升温并加大剂量化疗药物的方法 ,对 11例老年晚期肺癌患者进行治疗 ,疗效满意 ,现报道如下。 一、临床资料和方法 全组男 10例、女 1例 ,年龄 6 0~ 74岁 ,平均 (6 6 0± 4 5 )岁。鳞癌 5例 ,腺癌 2例 ,大细胞癌 3例 ,小细胞癌 1例。按1997年UICC新修订的肺癌国际癌症分类法 (TNM)分期 :T3 N1M0 2例 ,T3 N2 M0 5例 ,T4 N2 M0 4例。第 1秒最大呼气量(FEV1)在 1 0~ 2 4L之间者 8例 ,平均 (1 6± 0 3)L ;<1L者 3例。肿瘤位于右肺 6例 ,其中中心型 5… 相似文献
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目的研究老年胃癌术后早期腹腔热灌注化疗的可行性、安全性及疗效。方法选择规范胃癌根治术后的老年胃癌患者168例,随机分为腹腔内热灌注化疗组(5-FU+奥沙利铂)和全身化疗组(5-FU+奥沙利铂),比较两组的术后并发症、不良反应、生存率、复发率和转移率。结果两组术后并发症发生率无显著性差异。两组不良反应分度及严重毒副反应比较无显著性差异。两组生存率比较有显著性差异(P0.05)。两组局部复发率、远处转移率比较有显著性差异(P0.05)。结论老年胃癌术后早期腹腔持续温热灌注化疗可减少局部复发率和远处转移率,提高生存率;有利于胃癌术后腹腔内较小的残余癌或游离癌细胞的杀灭。 相似文献
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内生场腹腔热灌注化疗治疗晚期原发性肝癌的临床观察 总被引:1,自引:0,他引:1
目的观察内生场腹腔热灌注化疗治疗晚期原发性肝癌患者的安全性和疗效。方法对42例晚期原发性肝癌患者进行以顺铂联合氟尿嘧啶为主的内生场腹腔热灌注化疗,观察化疗前后的效果。另39例原发性肝癌给予一般支持治疗。结果经腹腔热灌注化疗,总有效率(RR)59.5%,腹水控制率81%,两组差异有统计学意义。治疗组和对照组中位生存期分别为17个月和3个月,差异有统计学意义(P〈0.05)。治疗组和对照组累计生存率比较差异有统计学意义(P〈0.05)。副作用主要为乏力、出汗。结论内生场腹腔热灌注化疗对晚期原发性肝癌有较好的控制,且安全性好。 相似文献
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三维适形放疗联合GP方案同步治疗局部晚期非小细胞肺癌临床观察 总被引:3,自引:1,他引:2
目的探讨三维适形放疗联合GP方案同步化疗治疗局部晚期非小细胞肺癌的近期疗效和急性毒副反应。方法40例Ⅲ期非小细胞肺癌患者采用三维适形放疗,同时予GP方案化疗(G:吉西他滨1000mg/m^2,第l,8天;P:顺铂30mg/m^2,第1-3天,每28天1个周期)。结果肺原发灶总有效率为85%;纵隔转移淋巴结总有效率为91.9%,急性毒副反应主要是骨髓抑制、胃肠道反应和轻中度放射性食管炎、放射性肺炎,均可耐受。结论三维适形放疗与GP方案同步放化疗治疗局部晚期非小细胞肺癌有较好近期疗效。 相似文献
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老年人所患膀胱癌分化多较差,恶性程度较高,预后相对较差.多种治疗联合、针对肿瘤的不同特征进行治疗已经成为肿瘤治疗发展的一个趋势.本研究采用三维适形放疗(3D-CRT)、同步化疗、热疗加平消胶囊治疗晚期膀胱癌,治疗效果满意.
1资料与方法
1.1 临床资料2006年10月至2008年10月收治34例晚期膀胱癌患者,均经术前膀胱镜检查及术后病理检验证实为膀胱癌,病理类型:移行上皮癌29例,鳞癌2例,未分化癌3例;临床分期为Ⅲ、Ⅳ期及局部复发病例. 相似文献
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目的探究经尿道膀胱肿瘤电切术(TURBT)后吉西他滨与吡柔比星膀胱热灌注化疗对老年浅表性膀胱癌患者的疗效和安全性。方法回顾性分析2012年4月至2015年4月在北京老年医院泌尿外科行TURBT治疗的老年浅表性膀胱癌患者90例,根据膀胱热灌注化疗药物不同分为吉西他滨组和吡柔比星组,每组45例。吉西他滨组患者1000 mg吉西他滨加入到0. 9%氯化钠溶液500 ml软包装中加热至50℃,吡柔比星组患者40 mg吡柔比星加入到5%葡萄糖溶液500 ml软包装中加热至50℃,2组患者术后6 h内都以300 ml/min流量模式进行循环灌注,治疗1 h,以后每周以同样方法膀胱热灌注1次,共8次。然后每月1次,持续1年。随访比较2组患者的肿瘤复发率、无复发生存时间和不良反应发生情况。应用SPSS 17. 0统计软件对数据进行分析。组间比较采用t检验或χ2检验。无复发生存时间采用Kaplan-Meier生存曲线,比较用Log-rank检验。结果全部病例随访12~36个月,2组患者12个月[8. 89%(4/45) vs 15. 56%(7/45),P=0. 334]和36个月复发率[15. 56%(7/45) vs 28. 89%(13/45),P=0. 128]差异无统计学意义。吉西他滨组患者相比吡柔比星组患者的无复发生存时间长[(32. 99±1. 53) vs (27. 71±1. 95)个月,P=0. 047],总不良反应发生率低[42. 2%(19/45) vs 97. 8%(44/45),P 0. 05]。吉西他滨组患者血尿、尿痛、膀胱炎发生率与吡柔比星组患者差异具有统计学意义(P 0. 05)。结论 TURBT后吉西他滨膀胱热灌注化疗疗效满意,不良反应轻,是预防老年浅表性膀胱癌患者术后复发的有效方法。 相似文献
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三维适形放疗同步化疗治疗中晚期食管癌的疗效与安全性观察 总被引:4,自引:0,他引:4
目的观察三维适形放疗同步化疗治疗中晚期食管癌的疗效与安全性。方法选择67例不能手术的食管癌患者,采用三维适形放射治疗(3D-CRT)同步化疗,化疗先采用DP方案:多西紫杉醇75mg/m^2,第1天;顺铂40mg/m^2,第1、2、3天,21d为一周期,共化疗2个周期,放疗结束后继续化疗4个周期。放疗从第1天开始,DT60-66Gy,分30~33次进行,6~6.5周完成。结果完全缓解39例,部分缓解22例,有效率91.0%;1、2、38局部控制率分别为80.5%、73.1%、46.2%;1、2、3a生存率分别为83.5%、77.6%、52.2%。毒副反应主要为白细胞下降、血小板下降和放射性食管炎,均以Ⅰ-Ⅱ度为主;放射性肺炎发生率较低,且均为Ⅰ-Ⅱ度。结论采用DP方案化疗同步3D-CRT治疗食管癌的近期疗效和局部控制率较好,可以提高患者生存率,虽然毒副反应增加,但患者基本可以耐受。 相似文献
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腹腔热灌注化疗药物及常温灌注生物制剂治疗癌性腹腔积液疗效观察 总被引:1,自引:0,他引:1
王增会 《实用心脑肺血管病杂志》2012,20(6):1052
目的 探讨腹腔热灌注化疗药物及常温灌注生物制剂治疗癌性腹腔积液的疗效.方法 适当引流腹腔积液,然后行腹腔热灌注顺铂(CDDP)+氟尿嘧啶,另加常温灌注白介素-2、地塞米松、利多卡因、庆大霉素,以减轻化疗药物的局部刺激.1~2次/周,腔内化疗1~6次,平均3次.结果 本组35例有效29例,有效率为82.86%.结论 腹腔内热灌注化疗及常温灌注生物制剂治疗癌性腹腔积液有效且不良反应少. 相似文献
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《中国老年学杂志》2014,(14)
目的探讨射频热疗配合热灌注化疗治疗老年恶性腹腔积液的临床疗效。方法选取老年恶性腹腔积液患者57例行射频热疗配合热灌注化疗治疗。结果治疗后,显效36.84%(21/57),有效50.88%(29/57),总有效率87.72%。老年患者腹水量由治疗前的中、大水平(分别为35和22例)转变为无34例、少18例、中4例以及大1例。治疗后CR、PR、SD、PD患者所占比例分别为49.1%(28/57)、40.4%(23/57)、10.5%(6/57)和0%。显效组6例出现副作用,有效组有9例患者出现副作用,无效组有1例患者出现副作用。患者出现白细胞下降、血小板下降、恶心呕吐、腹泻、BUN、Cr升高、肝损害、肾损害、手足综合征、脱发以及腹痛等副反应的比例分别为19.3%(11/57)、10.5%(6/57)、21.1%(12/57)、7.0%(4/57)、8.8%(5/57)、12.3%(7/57)、10.5%(6/57)、12.3%(7/57)、7.0%(4/57)以及15.8%(9/57)。结论射频热疗配合热灌注化疗治疗老年恶性腹腔积液疗效好,副作用的发生率较低。 相似文献
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《中国老年学杂志》2015,(13)
目的评价老年胃癌患者术后腹腔热灌注化疗联合静脉化疗的疗效和安全性。方法选取2008年2月至2012年2月收治的进展期胃癌术后患者100例作为研究对象,应用随机数字表法将患者随机分为两组,每组50例,对照组采用单纯常规静脉化疗,观察组术后即时采用腹腔循环热灌注化疗联合常规静脉化疗,比较两组的近期疗效、功能状态、局部复发率、生存率及不良反应。结果观察组患者近期总有效率为64.0%,明显高于对照组36.0%(χ2=4.012,P0.05);观察组患者CD3+、CD4+、CD4+/CD8+等指标明显高于对照组,而CD8+明显低于对照组(P0.05);观察组治疗后改善与稳定患者占78.0%,其中食欲增加35例(70.0%),体质量增加28例(56.0%)。对照组治疗后改善与稳定患者占62.0%,其中食欲增加17例(34.0%),体质量增加12例(24.0%)。两组功能状态评分比较差异显著(P0.05);观察组患者治疗过程中恶心呕吐、局部烫伤、骨髓抑制、脱水、肝功能损害、肾功能损害等不良反应发生情况与对照组比较无差异(P0.05);两组患者1年生存率比较无差异(P=0.440);治疗组2年生存率高于对照组(P=0.001);治疗组的3年生存率高于对照组(P=0.002);3年随访期间,观察组4例患者复发,复发率为8.0%;对照组12例患者复发,复发率为24.0%。两组复发率对比,观察组明显低于对照组(χ2=4.523 1,P=0.033 4)。结论老年胃癌术后早期腹腔循环热灌注化疗联合静脉化疗可减少局部复发率、远处转移率,提高生存率,是一种安全有效的治疗方法。 相似文献