Acute leukemia in patients with breast cancer

Symptoms related to pancytopenia were the earliest signs of acute myelogenous leukemia (AML) in two patients with breast cancer. Although some patients with breast cancer may be predisposed to AML, prolonged treatment with alkylating agents may be leukemogenic.     

Quality of life of women treated with radiotherapy for breast cancer

Goals of work Radiotherapy is routinely used in the treatment of early breast cancer, particularly in women who have undergone lumpectomy. Its impact on the quality of life of patients is important and is taken into consideration when making informed choices about treatment from both a patient’s and health professional’s point of view. This study reports on the quality of life of women at baseline, the completion of radiotherapy and 7 months after the completion of radiotherapy. Materials and methods European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C-30 and BR-23 questionnaires were used to evaluate quality of life of 61 women treated with radiotherapy for breast cancer. Additionally, demographic and treatment variables were analysed in relation to quality of life outcomes to determine if there were any significant predictors of quality of life. Main results There was no difference in quality of life of women at baseline, completion and 7 months after completion of radiotherapy. Fatigue and breast symptoms increased during radiotherapy but returned to baseline levels at 7 months. Fatigue was the strongest predictor of poor quality of life in women after radiotherapy. Conclusion Women retain a high quality of life and return to baseline function by 7 months after radiotherapy. Treatment may best be targeted to alleviate fatigue and breast symptoms during radiotherapy.     

乳腺癌患者放射治疗后皮肤反应的护理

<正> 放射治疗是预防乳腺癌术后局部复发的最有效的手段之一。当放射线穿过皮肤时,会造成一定的损伤,引起放射性皮炎。由于乳腺癌患者在放射治疗过程中易发生急性放射性皮肤损伤,加之乳腺癌手术后局部血液供应及淋巴回流较差。因此,加强患者照射野皮肤的观察和护理,有利于放射治     

乳腺癌患者曲妥珠单抗治疗中的细节管理护理

目的:探析乳腺癌患者曲妥珠单抗治疗中应用细节管理护理的临床效果。方法:纳入2017年1月至2019年12月常州市肿瘤医院收治的80例乳腺癌患者,将其随机分为两组,各40例。两组患者均给予曲妥珠单抗治疗,对照组治疗期间予以常规护理,实验组治疗期间予以细节管理护理,比较两组患者护理前后心理状态评分、护理质量评分及护理满意度。结果:护理后,实验组在抑郁、焦虑评分上与对照组比较差异有统计学意义(P<0.05)。实验组患者对基础护理、护理技能、健康教育、护理服务态度的评分均明显高于对照组,差异有统计学意义(P<0.05)。实验组护理满意度(97.50%)显著高于对照组(82.50%),差异有统计学意义(P<0.05)。结论:在乳腺癌患者曲妥珠单抗治疗期间给予细节护理管理,效果肯定,值得临床推广。     

The role of external beam radiotherapy in the management of differentiated thyroid cancer.

Well differentiated thyroid cancers (DTC), usually having an indolent course, are generally treated by surgery, i.e., total or near total thyroidectomy, followed by radioiodine and TSH suppressive therapy with thyroid hormone. The beneficial effect of external beam radiotherapy (EBRT) in the treatment of selected metastatic sites (i.e., brain and bone) or for palliation in cases of locally advanced inoperable disease is widely accepted. In contrast, its efficacy in improving postoperative locoregional disease control is still controversial. A better definition of subgroups of patients at high risk of local failure is mandatory. At present, patients older than 40-45 years affected by papillary cancers with macro- or microscopic postoperative residual disease and with extensive extrathyroid invasion appear to benefit from EBRT performed in addition to surgery and radioiodine. The role of EBRT in patients with radioiodine non-responsive progressive disease will also be discussed.     

鼻咽癌放射治疗患者心理干预的远期效果评价

目的 探讨心理干预对鼻咽癌放射治疗患者情绪及远期疗效的影响.方法 将100例鼻咽癌患者随机分为心理干预组(心护组)和对照组各50例.心护组患者除接受与对照组相同的放射治疗和疾病护理外,还接受心理干预.比较2组患者治疗前后焦虑和抑郁情况及2组患者的生存率.结果 治疗前2组患者焦虑和抑郁的分值比较无显著差异,而治疗后心护组焦虑和抑郁的分值均显著低于对照组.心护组1,3,5年生存率分别为100.0%、94.0%和85.9%,对照组分别为96.0%、85.6%和70.7%,心护组生存率高于对照组.心护组从放射治疗结束到发生复发或远处转移的间隔时间为(32.22±16.82)个月,对照组为(20.73±13.06)个月,2组比较无显著差异.结论 心理干预能改善鼻咽癌放射治疗患者焦虑、抑郁的情绪,并具有延长复发和转移发生的时间和提高生存率的趋势,值得进一步研究.     

The effect of adjuvant radiotherapy on skin biophysical properties in patients with breast cancer at risk for breast lymphedema: A prospective study

Breast cancer (BC) is the most common type of cancer among women. Radiotherapy (RT) is one of the main and primary treatment options for BC, especially in breast-conserving surgery (BCS). BC patients who underwent RT experience a wide range of symptoms, in which breast oedema and irritation of the skin take the lion's share. Breast oedema/lymphedema, which is also a prominent side effect after RT should be well determined in earlier settings due to the chronicity of lymphedema. Therefore, this study aimed to analyze the biophysical parameters of skin on the ipsilateral (IL) and contralateral (CL) sites via Tissue dielectric constant (TDC) and Transepidermal water loss (TEWL) methods in terms of oedema and skin barrier function (SBF). The following reference points before and after the RT were measured: (R1: Pectoralis muscle, R2: Upper breast, R3: Lower breast, R4: Lateral site of the thorax). A total of 24 BC patients (mean age and BMI: 52.78 ± 9.85 years and 28.42 ± 5.64 kg/m²) were evaluated. In the IL site, the SBF was not found significant in R1-R3, whereas significantly lower SBF was observed in R4 after RT (t = −3.361, p = 0.003). A significant increase in TDC was observed in R2 at the 5.0 mm depth (t = −2.500, p = 0.02). We suggest that a longer period of follow-up should be carefully carried out to track changes in terms of SBF and oedema in the irradiated breast. The increased need for early detection of changes associated with breast lymphedema can be achievable via noninvasive, safe, cheap, and easily repeatable devices.     

赫赛汀治疗乳腺癌患者的护理

赫赛汀(Herceptin)又称曲妥珠单抗,自1998年获美国食品药品管理局(FDA)批准上市以来,目前已被获准用于晚期人表皮生长因子受体-2(HER2)阳性乳腺癌及经手术和标准化疗后的早期HER2阳性乳腺癌患者.作者在近2年的赫赛汀的临床应用中,总结了一些预防和减轻其不良反应的护理方法,现报道如下.     

Acute and anticipatory emesis in breast cancer patients

A group of 90 breast cancer patients undergoing chemotherapy were assessed prospectively to estimate the prevalence of acute (post-treatment) and anticipatory emesis in the 1990s. For this purpose, two protocols of chemotherapy were analysed separately: cyclophosphamide/methotrexate/5-fluorouracil (CMF) and 5-fluorouracil/doxorubicin/cyclophosphamide (FAC). All patients were treated with antiemetic therapy, which included one corticoid plus ondansetron (in the FAC regimen), or one corticoid plus thiethylperazine (in the CMF regimen). For at least one cycle of chemotherapy 86.1% and 91.7% patients in the FAC protocol presented vomiting and nausea respectively; 11.1% had anticipatory vomiting and 30.6% had anticipatory nausea. In the CMF protocol, 79.6% had post-chemotherapy vomiting and 71.7% had post-chemotherapy nausea associated with at least one cycle. In this group, 7.4% had anticipatory vomiting and 16.6% had anticipatory nausea. A high proportion of patients suffered anticipatory anxiety in both groups (75% in FAC, 74.1% in CMF). The stimuli most frequently associated with the appearance of anticipatory emesis were olfactory stimuli and cognitive stimuli. In summary, as a result of the advances made in antiemetic control during the last decade, the severity of chemotherapy-induced emesis seems to have significantly decreased, but the prevalence of these symptoms along the course of the treatment still remains high.     

超声心动图评价蒽环类药对乳腺癌患者心脏毒性

目的探讨背向散射积分(IBS)参数测定技术在评价蒽环类抗肿瘤药(ATC)对乳腺癌患者心脏毒性方面的应用价值.方法应用Philips Sonos-5500型超声诊断仪测定39例接受ATC化疗的乳腺癌患者及29例正常对照组的常规超声心动图心功能参数以及心肌背向散射积分参数:心肌背向散射积分均值(IBS);背向散射积分的心动周期变化幅度(CVIB);心肌校正的背向散射积分均值(IBS%)和背向散射积分周期变异率(CVIB%).结果乳腺癌化疗组IBS的周期性变化幅度明显减低、心肌IBS%较对照组明显增高(P<0.05)、CVIB和CVIB%则较对照组明显减低(P<0.05,P<0.01);乳腺癌化疗组有14例出现左心室舒张功能指标异常;但左心室收缩功能参数在ATC化疗组和对照组之间无显著性差异;IBS参数与ATC累积剂量、距首次化疗时间、心功能参数及相应节段的室壁增厚率均无显著相关性.结论背向散射积分参数测定可作为评价乳腺癌患者应用ATC早期心脏毒性的手段之一.     

循证护理在乳癌术后放疗皮肤反应中的应用

目的应用循证护理探讨乳癌术后放疗患者皮肤反应的有效干预方法。方法根据76例患者产生皮肤反应的具体情况,提出护理问题,收集相关证据,结合实际制订切实可行的护理计划,采取相应的护理措施。结果76例患者干预后皮肤反应均得以缓解,减轻了患者的痛苦,患者能顺利完成放射治疗,达到有效的照射剂量。结论应用循证护理找出乳癌放疗患者皮肤损伤因素,采用循证护理寻求科学完整的护理方案,有助于提高护理质量。     

乳腺癌患者保乳手术后联合放射治疗的临床治疗效果探讨

目的:分析乳腺癌患者实施保乳手术后联合放射治疗的临床价值。方法:纳入我院于2014年2月到2017年2月期间接收的乳腺癌患者148例为本次研究对象,通过抽签法形式分为研究组和对照组,其中研究组76例,对照组72例。对照组行乳腺癌根治术处理,研究组行保乳手术联合放射治疗,记录两组肿瘤转移率,肿瘤复发率,肿瘤生存率以及不良反应发生率。结果:研究组3年肿瘤转移率0.00%、生存率94.74%和对照组2.78%、91.67%比较不具有差异性(P>0.05),研究组3年肿瘤复发率2.63%低于对照组13.89%,组间比较存在差异性(P<0.05);对照组不良反应发生率27.78%和研究组23.68%对比,不具有统计学意义(P>0.05)。治疗前,研究组和对照组患者血清2-MG、CEA、CA15-3、CA125、YKL-40水平对比,不具有统计学意义(P>0.05);两组治疗后对比,存在统计学意义(P<0.05)。结论:乳腺癌患者实施保乳手术联合放射治疗,相比于乳腺根治术效果更为完善,有利于临床医学进一步推广分析。     

共情护理对乳腺癌放疗患者心理痛苦的影响

目的:探讨共情护理对乳腺癌放疗患者心理痛苦的影响.方法:选取120例乳腺癌住院患者为研究对象,按照人院先后顺序分为对照组和观察组各60例.对照组行放疗常规护理,观察组在对照组基础上运用共情护理.采用心理痛苦温度计(DT)及其问题列表(PL)、医院焦虑抑郁量表(HADS)、乳腺癌患者生活质量测定量表(FACT-B)评价两...     

The validity of skin care protocols followed by women with breast cancer receiving external radiation

Skin care in women receiving external radiation to the breast varies among institutions. Studies have been conducted looking at the effect that various skin care products have on the onset and severity of radiation-induced skin reactions in those patients. Results show that no significant difference exists among these products. The practice of avoiding aluminum-based deodorant on the treated side and avoiding use of any skin care products four hours prior to treatment is not evidence based but often is part of skin care protocols for women receiving breast irradiation. A review of the literature since 1996 in the United States, Canada, United Kingdom, and Australia revealed some evidence to refute the practice but no supporting evidence. Because minimal disruption in a woman's normal hygiene routine could mitigate anxiety and improve coping during a time of extreme stress brought on by a cancer diagnosis, further research is warranted to support changing the practice.     

赫赛汀在乳腺癌病人治疗中的观察及护理

随着生物技术的发展,抗癌新药赫赛汀(herceptin)作为单克隆抗体药物,专门针对过量表达癌基因HER-2的细胞,并激发免疫系统杀死靶细胞,对HER-2过度表达的乳腺癌病人有一定的疗效.本文主要报道21例乳腺癌病人使用赫赛汀治疗时对药物溶媒的选择、用药剂量的计算以及药液配制和治疗全过程的注意事项,归纳了药物毒副反应及相应护理措施.     

Psychological functioning associated with prostate cancer: cross-sectional comparison of patients treated with radiotherapy, brachytherapy, or surgery

This study compared the prevalence of psychological difficulties (i.e., anxiety and depression), psychophysiological problems (i.e., insomnia and fatigue), and sexual difficulties across three modalities of treatment for prostate cancer (radiotherapy, brachytherapy, and radical prostatectomy). A total of 861 men completed a battery of questionnaires assessing anxiety, depression, fatigue, insomnia, and quality of life. Patients who initially received radiotherapy had higher levels of depression, anxiety, and fatigue and a lower quality of life, and were more likely to report clinical levels of depression and fatigue. Patients who initially received surgery were more likely to report clinical levels of sexual difficulties but less likely to report clinical levels of depression and fatigue, while patients who received brachytherapy were less likely to report sexual difficulties. Although cross-sectional, these findings raise the possibility of a differential influence of treatments for prostate cancer on some aspects of psychological functioning.     

A longitudinal study of symptoms and self-care activities in women treated with primary radiotherapy for breast cancer

The purpose of this prospective longitudinal study was to describe the occurrence, severity, and pattern of symptoms experienced by women during and after primary radiation therapy for breast cancer. A convenience sample of 30 women was recruited from a community hospital. The Symptom Profile by King et al (Oncology Nursing Forum. 1985;12(4):55-61) was adapted to measure 11 symptoms, and the Profile of Mood States assessed psychological status. Data were collected weekly during radiation and monthly for 3 months after treatment. There was a pattern of increasing incidence during treatment for the most commonly reported symptoms: fatigue (33%-93%), skin changes (36%-100%), sensation changes (28%-79%), and breast swelling (11%-38%), with gradual improvement over the following 3 months. Sleep problems were reported by nearly half of the subjects during and after treatment. Severity ratings of symptoms were mild to moderate but significantly higher by the end of therapy (P 相似文献   

健康教育对乳腺癌术后放疗皮肤反应的影响

目的：探讨健康教育对乳腺癌术后放疗皮肤反应的影响。方法：将225例乳腺癌术后放疗患者作为实验组进行有针对性的健康教育,将246例做常规护理的乳腺癌术后放疗患者作为对照组,比较两组患者放疗后皮肤反应的情况。结果：实验组在放疗后皮肤反应明显低于对照组（P＜0.05）。结论：运用护理程序对患者进行有针对性的健康教育,能有效减轻患者放疗后皮肤反应,减轻患者痛苦,提高生存质量。