TP联合化疗治疗非小细胞肺癌所致毒副反应的观察和护理干预

目的:观察多西他赛(TAX)加顺铂(DDP)联合化疗治疗晚期非小细胞肺癌(NSCLC)所致的毒副反应并探讨护理方法.方法:74例Ⅲ～Ⅳ期NSCLC患者采用TAX接75 mg/m2,静注,第1天;DDP按30 mg/m2静滴,1～3 d,联合化疗,21天为1个周期,共2个周期以上.结果:本组发生粒细胞减少71例,恶心、呕吐64例,静脉炎45例,皮下外渗1例,过敏反应、体液潴留、神经毒性、肝功能损伤较轻,出现不良反应时,及时进行护理干预和对症处理,均得到有效控制.结论:TP联合化疗治疗晚期NSCLC效果较好,严密观察和良好的护理可最大程度减轻毒副反应.     

多西他赛联合顺铂并同期MM50适形放疗治疗食管癌近期疗效观察

目的:观察多西他赛联合顺铂并同期MM50适形放疗治疗晚期食管癌的临床疗效和毒副反应。方法:对60例食管鳞状细胞癌随机分为实验组和对照组,两组均给予适形放射治疗,对照组采用单纯放疗,实验组采用多西他赛联合顺铂化疗并配合适形放疗。结果:实验组有效率和毒副反应均高于对照组。1、2、3年生存率对照组和实验组分别为60.0%、40.0%、23.3%及80.0%、66.7%、43.3%。1、2、3年局部控制率分别为46.7%、40.0%、26.7%及76.7%、63.3%、53.3%。生存率及局控率实验组明显高于对照组(P<0.05)。结论:选择多西他赛联合顺铂的同期化疗配合适形放疗的治疗方案能达到更好的治疗效果,能提高生存率和生存时间,值得临床考虑。     

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。     

多西他赛、环磷酰胺与多西他赛、吡柔比星新辅助化疗方案治疗局部晚期乳腺癌疗效分析

目的观察多西他赛、环磷酰胺（DC方案）与多西他赛、吡柔比星（DT方案）新辅助化疗方案治疗局部晚期乳腺癌的临床疗效和不良反应。方法经麦默通穿刺确诊局部晚期乳腺癌可手术患者73例,随机分为DC组（35例）,DT组（38例）,分别给予DC方案,DT方案化疗3个周期,DC组35例,DT组38例化疗结束2周后行乳腺癌改良根治术。比较DC组,DT组疗效和不良反应,治疗前、后TNM分变化、术后并发症及化疗前后ER、PR、HER2变化比较。结果临床疗效比较DT组优于DC组,其差异有统计学意义（P〈0．05）;TNM分期均较新辅助化疗前降低（P〈0．05）,不良反应比较差异无统计学意义（P〉0．05）;术后并发症比较差异无统计学意义（P〉0．05）,ER、PR均为阴性患者对化疗敏感,DT方案对于HER2高表达患者疗更敏感。结论DT及DC新辅助化疗方案疗对局部晚期乳腺癌均有效,DT方案优于DC方案。     

吉非替尼联合艾迪注射液治疗晚期非小细胞肺癌的临床观察

目的:评价吉非替尼联合艾迪注射液治疗晚期非小细胞肺癌的近期疗效和不良反应.方法:将44例患者随机分为两组,每组22例患者.治疗组给予艾迪注射液联合吉非替尼治疗.吉非替尼给予250mg每天口服一次,艾迪注射液给予50ml每天一次静脉输入.对照组仅予吉非替尼250 mg每天口服一次治疗.结果:全部44例患者可评价疗效,治疗组和对照组有效率为40.9％和27.3％.疾病控制率分别为86.4％和59.1％.治疗组在疗效和疾病控制率均高于对照组,其中两组疾病控制率相比较具有统计学意义(P＜0.05).常见不良反应多为Ⅰ～Ⅱ度皮疹改变和腹泻,但通常可能耐受.结论:吉非替尼联合艾迪注射液治疗晚期非小细胞肺癌,可以提高疗效及降低治疗的相关毒副作用.     

紫杉醇联合卡铂治疗晚期非小细胞肺癌疗效观察

目的 观察紫杉醇联合卡铂治疗晚期非小细胞肺癌疗效及不良反应。方法 29例晚期非小细胞肺癌患者给予紫杉醇联合卡铂治疗，其中紫杉醇135mg／m^2，第1天静滴，卡铂300mg/m^2，第1天静滴，28d为1个周期，每例患者治疗2个周期以上。结果 全组无完全缓解病例，部分缓解13例，稳定10例，进展6例，总有效率44．8％。初治组有效率为46．1％，复治组有效率为43．8％，两组间有效率差异无显著性（P〉0．05），KPS评分增加者占65．5％（19／29）。最常见的毒副反应为骨髓抑制，Ⅲ～Ⅳ度白细胞和血小板下降分别为34．5％和10．3％，其他毒副反应轻微，均可耐受。结论 紫杉醇联合卡铂治疗晚期非小细胞肺癌，无论初治或复治均有较高有效率，且本方案还能改善患者的机体功能状态。     

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。     

多西他赛联合长春瑞滨在乳腺癌治疗中的应用

多西他赛和长春瑞滨均为植物碱类抗肿瘤药物,广泛用于乳腺癌治疗中,有较高的抗肿瘤活性及可耐受的毒性反应.因其独特的作用机制,多西他赛、长春瑞滨联合应用逐渐引起重视,现综述多西他赛联合长春瑞滨在乳腺癌治疗中的应用.     

Pharmacokinetic analysis of docetaxel during haemodialysis in a patient with locally advanced non-small cell lung cancer.

Sir, Management of localized stage III non-small cell lung cancer(NSCLC) patients has improved significantly in recent years.Nevertheless, there exist few case reports about chemotherapeuticregimens of patients with end-stage renal disease (ESRD) andNSCLC [1,2]. Docetaxel (DXL) in combination with carboplatinis successfully used in the     

CT引导经皮肺穿刺间质治疗晚期非小细胞肺癌

目的探讨CT引导经皮肺穿刺瘤内注射化疗药物治疗(间质治疗)晚期非小细胞肺癌(NSCLC)的临床应用及疗效。方法收集晚期NSCLC患者586例,肺内癌灶1026个,在CT引导下经皮细针穿刺至癌灶内并注射抗癌化疗药物,按WHO实体瘤疗效评价标准进行评价,并定期随访。结果穿刺成功率100%,肿瘤内注射药物成功率100%。主要并发症有发热(215/586,36.69%)、局部疼痛(305/586,52.05%)、气胸(38/586,6.48%)、瘤周出血(26/586,4.44%)、针道出血(37/586,6.31%)、痰中带血(71/586,12.12%)等。治疗有效率为76.28%(447/586),疾病控制率为90.44%(530/586)。随访6个月生存率为81.74%(479/586),1、2、3年生存率分别为63.48%(372/586)、35.67%(209/586)、19.28%(113/586)。结论 CT引导经皮肺穿刺间质治疗晚期NSCLC操作简便,并发症少,患者耐受性好、近期疗效显著,值得临床推广应用。     

长春瑞滨联合顺铂治疗晚期非小细胞肺癌64例疗效观察

目的观察长春瑞滨联合顺铂化疗治疗晚期非小细胞肺癌的疗效和毒副反应。方法长春瑞滨25mg/m2,第1、8天静滴;DDP40mg,第1、2、3天滴注,21d为1个周期。最少应用两个周期。结果 CR0例,PR28例,SD26例,PD10例,有效率为43.75%。主要不良反应为骨髓抑制、消化道反应及静脉炎。结论 NVB＋DDP方案治疗NSCLC疗效较好,毒副反应较轻,可以耐受。     

Multi-modality treatment of non-small cell lung cancer

Despite significant advances in radiation therapy techniques and a variety of newer chemotherapeutic agents, when multimodality treatment for stage I and II tumors has been tested by Phase III randomized prospective trials of adequate size, no significant survival advantage over surgery alone has been found in most instances. Modalities tested include preoperative radiation therapy, and postoperative chemotherapy and radiation therapy. Trials are presently underway to test preoperative chemotherapy for stages Ib, II, and T3NI (S9900) and to test adding surgery for patients with N2 disease who have been treated by chemotherapy and radiation therapy (INT 0139). Results of a recently completed trial (JBR10) will answer the question of whether postoperative chemotherapy is of benefit for patients with stages T2N0 or T1-2N1. Until these trials are completed, surgeons should resist the temptation to use newer but unproven therapies except within established approved protocols.     

晚期非小细胞肺癌抗血管生成治疗:文献复习及病例报道

【摘要】〓肺癌是我国死亡率最高的癌症,其中非小细胞肺癌占多数。近年来研究表明,抗血管生成药物在多种实体瘤包括非小细胞肺癌中表现出了显著的疗效。阿帕替尼作用于血管内皮生长因子受体(VEGFR),临床研究证实目前其主要适应症为晚期胃癌。近年来在晚期非小细胞肺癌患者中应用阿帕替尼的临床实践日益增多,但相关报道极少。现将本院在晚期非小细胞肺癌中应用阿帕替尼的临床病例报告如下并做相关文献复习。     

Preoperative and adjuvant chemotherapy in locally advanced non-small cell lung cancer

The continued favorable results with surgery in early stage lung cancer have led many investigators to use radiation and chemotherapy to reduce the size of unresectable tumors either before or after definitive surgery. Although earlier results with both radiation and chemotherapy have been poor, the newer cisplatin-containing combination chemotherapy regimens have yielded decreased local recurrence rates when used postoperatively following a complete resection and have produced increased complete resection rates when given preoperatively to patients with locally advanced and unresectable non-small cell lung cancer at diagnosis.     

Small sized non-small cell lung cancer in advanced stage]

Eighteen cases of non-small cell, small sized advanced lung cancer, out of 362 operated cases for 6 years excluding 7 cases of small cell lung cancer, 60 of preoperative treated and 27 of inoperable cases, were discussed. A small sized tumor was defined as a tumor within 8,000 mm3 in its volume, calculated by multipling three lengths measured on the resected specimens. There were fourteen cases with stage 3 and 4 (A), and four cases with N1 disease (B). In group A, three cases of twelve with N2 diseases showed the tiny skipping lesion in the mediastinum with negative regional nodes. Remaining two had a lesion of dissemination and pulmonary metastasis. In group B, they showed unusual way of N1 spread, in which two of them with left upper lobectomy had metastatic lymph nodes on the non-bearing lobe, the lower lobe, and other two cases took regional lymph nodes metastasis without invasive growth of the main tumor. Predominant histologic type was adenocarcinoma, but the subtype and the differentiation of it were not specific. The level of CEA was low below 5 ng/dl in most of them except three cases, in which it suggested massive positive nodes and pulmonary metastasis. Seven patients died of the disease in two years. Remainders are alive, 4 with and 7 free from the tumor with the longest period of 3 years and a half. N2 diseases of small sized tumor were found in the cases with the volume of 3 cm3 and more at almost same ratio.(ABSTRACT TRUNCATED AT 250 WORDS)     

Surgical treatment of non-small cell lung cancer in octogenarians

As the European population ages, surgeons are regularly faced with octogenarians with resectable early stage non-small cell lung cancer (NSCLC). We compared our experience with those reported in the literature to comprehend the feasibility, outcomes and lessons learned regarding surgical treatment. We reviewed octogenarians who underwent lung resection for NSCLC in the past nine years in our Department. The purpose of this paper is to retrospectively analyse postoperative surgical and oncological outcomes of our series, trying to find possible correlations between mortality, morbidity, survival and preoperative oncological and functional assessment, surgical approach and extent of resection. Eighty-two patients (M/F = 63/19), with a mean age 81.0 years (range 80-87 years) underwent lung resection for NSCLC: 63 lobectomies, one inferior bilobectomy, three segmentectomies, and 15 wedge resections. There were two perioperative deaths (2.4%). The overall complication rate was 30.0%, with a major complication rate of 2.5%. Actuarial cancer-related survival rates at one, three and five years were 90%, 44% and 36%, respectively, with a statistically-significant correlation with pathological stage. Octogenarians may benefit from surgical treatment of NSCLC with an acceptable morbidity and mortality rate, if an accurate preoperative selection is pursued.