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肿瘤的分子靶向治疗现状 总被引:1,自引:0,他引:1
目前,化疗、放疗是除手术治疗外的肿瘤的主要治疗方法,然而其在杀死肿瘤细胞的同时也对正常组织细胞产生不可避免的严重损害。随着分子生物学研究的进展和肿瘤分子靶点的确立,肿瘤的靶向治疗已成为可能,并可能成为肿瘤治疗最有效的手段之一,具有广泛的应用潜能。本文对常用的几种肿瘤分子靶向治疗研究现状作一综述。 相似文献
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<正>靶向治疗是除手术、放疗、化疗外治疗肿瘤的一种新方法,是在无创或微创条件下以肿瘤为目标,采用有选择、针对性较强、病人易于接受、反应小的局部或全身治疗,最终达到有效控制肿瘤、减少肿瘤周围正常组织损伤目的的各种手段的总称。肿瘤的靶向治疗凭借其特异性与靶向性, 相似文献
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胃肠道肿瘤是世界上发病率和死亡率最高的肿瘤之一,尽管近些年传统治疗方法有了很大改进,但晚期胃肠道肿瘤的生存率仍较低。生物治疗已成为继手术、放疗、化疗后的第四种治疗模式,对改善胃肠道肿瘤的预后显示出了良好的应用前景。本文从基因治疗、免疫治疗及分子靶向药物治疗等几方面对近年来生物治疗在胃肠道肿瘤应用中的进展作一综述。 相似文献
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分子靶向药物在晚期胃肠道肿瘤治疗中,被证实可提高患者的客观缓解率并延长总生存期.因此,其在局部进展期胃肠道肿瘤综合治疗中的价值被逐渐重视.曲妥珠单抗用于HER-2基因阳性的局部进展期胃癌新辅助化疗中的临床研究正在进行中,结果值得期待.大量研究证明,西妥昔单抗联合化疗对于KRAS基因野生型潜在可切除的结直肠癌肝转移患者,能提高手术切除率并延长总生存期;而贝伐珠单抗在KRAS基因突变型结直肠癌肝转移术前转化治疗中的作用正在评估中.对于可切除的结直肠癌肝转移,虽现有的证据显示,分子靶向药物在新辅助治疗中未能带来长期生存益处,但最终结论仍存议甚多.对于局部进展期直肠癌患者,新辅助化疗中的西妥昔单抗在二期临床研究中未能显示治疗获益,贝伐珠单抗的作用同样需要在三期临床研究后进一步证实.与晚期肿瘤单一治疗模式不同,在肿瘤综合治疗中,需要系统评估分子靶向药物与细胞毒药物、手术以及放疗之间可能的相互影响及协同作用,制定出科学并适用于临床实践的综合治疗模式. 相似文献
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根治性膀胱切除以及尿流改道仍然是浸润性膀胱肿瘤的标准治疗,尽管盆腔解剖和手术技巧都有了很大进步,术后生存率仍然较低.为了改善生存率并兼顾生活质量,以手术为核心的综合治疗越来越受到重视.本文就放化疗、膀胱保留策略和分子靶向治疗等综合治疗中的焦点问题介绍如下. 相似文献
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Donatella Marino Federica Colombi Dario Ribero Massimo Agliett Francesc 《中国普通外科杂志》2013,22(8):973-975
10年中胆管癌(CC)的处理方法已经有了巨大的改变.仅仅在几年前,胆管癌晚期患者还没有效的治疗方案,只有支持治疗.并且在没有有效证据及随机研究结果的情况下,常给予患者姑息化疗.
根据两个随机试验的结果已经建立了一个新的治疗标准:吉西他滨和铂化合物的联合化疗方案已被证明能显著延长胆道肿瘤不能手术切除的患者的生存期[1-2].此外,新治疗方式的发展,包括具有开拓性的靶向性治疗也正开辟治疗CC的新途径[3].毫无疑问,考虑如何针对不同肿瘤类型使用新制剂治疗是个合乎时机的研究主题.一些Ⅱ期靶向药物研究,主要是抗-EGFR和VEGF药物,但是结果仍不明确. 相似文献
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纳米载体的出现,彻底改变了胃癌及其他肿瘤的传统治疗模式,使化疗药物在体内的分布更合理,靶向性更强,不良反应更轻,并且能对抗肿瘤细胞的耐药机制.在胃癌淋巴靶向化疗中应用纳米载体,不仅能够获得更好的疗效,还能指导手术,改进患者的生活质量,具有广阔的应用前景. 相似文献
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Opinion statement Optimal management of ependymomas includes surgical resection and evaluation of the extent of central nervous system involvement
using cerebrospinal fluid cytology and craniospinal contrast-enhanced MRI. In instances of measurable residual disease, reoperation
should be considered because survival of patients with ependymomas is significantly improved by performance of a complete
resection. In patients not considered for further surgery and with residual disease, limited-field radiotherapy is usually
administered. The role of craniospinal irradiation in patients with local disease and no evidence of metastasis is controversial
because most tumor recurrences are local and at the site of the primary tumor. No clear role for adjuvant chemotherapy has
been demonstrated. When used, chemotherapy for ependymomas has been administered primarily to children aged younger than 3
years as adjuvant therapy and to patients with recurrent disease who are not considered surgical candidates as salvage therapy.
Recurrent ependymomas are managed by reoperation of tumors that are surgically accessible, by radiotherapy if not previously
administered, and by salvage chemotherapy. The role of stereotactic radiotherapy administered as radiosurgery or brachytherapy
is unclear because all reports are anecdotal. Because salvage chemotherapy is not curative, no standard therapy exists, and
a variety of chemotherapy agents and drug schedules have been investigated. 相似文献
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Rhabdomyosarcoma (RMS) is a relatively frequent tumor in children. Judicious combinations have markedly improved treatment results in recent years. Orbital localizations are treated with chemotherapy and radiotherapy. It has been advocated that radiotherapy be limited to the original tumor bed. This case report illustrates the danger of shielding part of the orbit: in a clinically tumor-free region before chemotherapy, which was shielded during radiotherapy, a local recurrence was seen while the original tumor bed remained controlled. Therefore, the whole content of the orbit should be irradiated in orbital RMS. 相似文献
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新辅助化疗(NACT)是指针对潜在可根治切除的肿瘤患者,以消除微转移、降低肿瘤分期和手术难度、改善术后局部复发和远处转移等为目的,在肿瘤手术切除或放疗之前,先予以全身化疗,待手术或放疗之后继续完成全程化疗的综合方案。结肠癌是最常见的癌症之一,肿瘤根治性切除联合术后辅助化疗是临床潜在可根治切除结肠癌的主要治疗方式。虽然这种治疗模式较前显著改善了患者的预后,但术后局部复发和远处转移仍是患者最主要的致死因素。近年来NACT方案开始被引入局部进展期结肠癌和原发灶可切除的肝转移患者等潜在可根治切除结肠癌患者的治疗。然而,结肠癌患者是否适合NACT及其方案的选择还存在较大的争议。笔者就局部进展期结肠癌、可切除结肠癌肝转移等在NACT中的进展与争议,以及影像学检查对NACT的作用作一综述。 相似文献
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Adjuvant chemotherapy appears to be active in stage II-III rectal cancers; the NSAPB R01 trial demonstrated a survival advantage for patients receiving chemotherapy using the MOF protocol and 3 meta-analyses are in favor of the efficacy of adjuvant chemotherapy in rectal cancer. Three randomized trials have also demonstrated that combinations of radiation and chemotherapy are superior to surgery alone or adjuvant radiotherapy and demonstrated the major role of systemic chemotherapy combined with radiotherapy. However this efficacy of adjuvant chemotherapy alone or combined with radiation therapy is still debated and specific trials must be conducted to test the value of chemotherapy using more active regimens than those previously tested and taking into account the quality of surgery and radiotherapy; such trials are in progress, especially the trial conducted by the EORTC and the FFCD. The efficacy of neoadjuvant chemotherapy has never been clearly demonstrated, although a combination of radiotherapy and chemotherapy as first-line treatment for locally advanced rectal cancer and in the case of synchronous metastasis seems to facilitate surgical resection. It is a reasonable and tolerable approach with manageable toxicity which gives substantial results in 2/3 of patients. This strategy also allows better selection of patients likely to benefit from surgical resection of their primary tumor and in some cases of their synchronous metastases. However, the efficacy of perioperative treatments should not decrease the quality of the surgical resection and especially mesorectal excision as well as the need for high quality pathological examination which must be very thorough with analysis of a sufficient number of lymph nodes. The efficacy of combined treatment in advanced rectal cancers is a major argument in favor of the multidisciplinary coordination required for optimal treatment of patients with rectal cancer. 相似文献
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Yoshida Y Toma Y Arai M Higashi R Kashihara K Kaizaki Y 《No shinkei geka. Neurological surgery》2005,33(7):717-722
We report a case of primitive neuroectodermal tumor (PNET) arising 8 years after chemotherapy and radiotherapy for acute lymphoblastic leukemia. A 15-year-old boy with a history of acute lymphoblastic leukemia, at the age of 7, underwent chemotherapy and 14Gy of radiotherapy to the whole brain. He was admitted to our department due to the development of aphasia, right hemiparesis and generalized convulsive seizure. MRI showed an irregularly enhanced mass in the left frontal lobe. A gross total removal of the tumor was performed and histological examination showed it to be PNET. Postoperatively, the patient underwent 20Gy of radiotherapy to the whole brain and 42Gy of local radiotherapy. Follow-up MRI showed no evidence of recurrent tumor 4 months after the radiotherapy. This tumor was thought to be a secondary brain tumor arising in this survivor of childhood acute lymphoblastic leukemia and it is a rare complication of successful leukemia treatment. 相似文献
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Pisansky TM 《Urology》2003,62(Z1):36-45
Multiple oncologic treatment modalities are often integrated into the curative treatment approach for the patient with a newly established diagnosis of cancer. The combination of neoadjuvant and adjuvant therapies with radiotherapy for the care of the patient with prostate cancer is no exception. There is clear evidence that neoadjuvant androgen suppression reduces the volume of tumor in preparation for radiotherapy, and it is an effective addition to conventional-dose external radiotherapy in patients with large-volume primary prostatic tumors. Adjuvant androgen suppression improves local and systemic tumor control and improves survival duration compared with radiotherapy alone for patients with locally advanced or node-positive prostate cancer, particularly in those with high-grade disease. The role of neoadjuvant and adjuvant therapies is under intense scrutiny as several randomized clinical trials seek to optimize the combination of androgen suppression, chemotherapy, and radiotherapy. The historical precedent for combining androgen suppression with radiotherapy is described, as are the results of prior definitive trials and ongoing studies in this setting. 相似文献
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Treatment of Malignant Mesothelioma 总被引:7,自引:0,他引:7
Malignant pleural mesothelioma (MPM) is a rare tumor that predominantly afflicts men over 50 years of age. Nearly 3000 MPMs are reported annually in the United States with the incidence expected to rise into the new millenium. Over the past 40 years, MPM has been unequivocally linked to asbestos exposure worldwide. Recently, however, a new theory on the carcinogenesis of this tumor has been proposed with the isolation of a simian virus (SV 40)-like gene sequence in mesothelioma tumor cells. The clinical presentation of MPM is variable, although most patients typically present with dyspnea, chest pain, or pleural effusion. Obtaining a diagnosis of MPM has been greatly assisted by video-assisted surgery and the use of immunohistochemistry and electron microscopic techniques, which help distinguish MPM from other tumor pathologies such as adenocarcinoma. Computed tomography and magnetic resonance imaging have been also useful for determining tumor burden and resectability. Traditionally, strategies for the treatment of MPM have included supportive care, surgery, radiotherapy, and chemotherapy. Survival with supportive care alone ranges between 4 and 12 months. Single-modality therapy using traditional approaches (surgery, radiotherapy, chemotherapy) alone has failed to improve patient survival significantly. Recently, results using a multimodality approach have been favorable. In particular, cytoreductive surgery (pleuropneumonectomy) followed by sequential chemotherapy and radiotherapy have demonstrated improved survival, especially for patients with epithelial histology, negative resection margins, and no metastases to extrapleural lymph nodes. Innovative therapies such as the use of photodynamic, targeted cytokines and gene therapy are currently being investigated for management of MPM. 相似文献
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氧载体除用于血液代用品外,还可以用于肿瘤的治疗,以纠正肿瘤乏氧微环境,增强肿瘤放化疗敏感性,进而改善恶性肿瘤的疗效及预后。目前研究的氧载体主要包括以下几类:高氧液、氟碳化合物氧载体、血红蛋白氧载体、载氧脂质微泡。本文就氧载体的制备、作用机制及其对肿瘤放化疗增敏的研究现状及安全性进行综述。 相似文献