存活十年以上慢性粒细胞性白血病16例随访观察

我院1959-1991年诊治慢性粒细胞性白血病286例，其中16例长期存活十年以上，11例经马利兰间歇治疗，2例用马利兰与羟基脲交替治疗，2例为马利兰与靛玉红交替治疗，1例马利兰及马法兰交替治疗，其中最长生存年限为32年，16例中5例已死亡，该组病例经过COX危险因子测定，初诊时大部分为1-3分，间歇服用马利兰仍不失为治疗慢性粒细胞白血病的较好方法。     

大剂量马利兰治疗慢性粒细胞白血病13例临床分析

大剂量马利兰治疗慢性粒细胞白血病１３例临床分析郭仁慈马利兰是治疗慢性粒细胞白血病（ＣＭＬ）最常用的药物，其不同的治疗方法和剂量，对不同危险度组的治疗效果不尽相同，本文就大剂量马利兰治疗中高危组ＣＭＬ１３例报告如下。材料与方法病例１９８４年１２月～１９...     

蝮蛇抗栓酶与化疗药合用治疗慢性白血病

慢性白血病20例分为两组。1.蝮蛇抗栓酶与马利兰或瘤可宁合用组(治疗组)。该组共10例慢性白血病病人,男6例,女4例。平均56岁。其中,慢性粒细胞性白血病(慢粒)5例,慢性淋巴细胞性白血病(慢淋)5例。治疗方法为,慢     

慢性粒细胞白血病合并鼻咽癌1例

 马利兰是治疗慢性粒细胞白血病的传统药物，近来，有人提出马利兰在导致白血病发生方面具有重要作用，主要是因为它有细胞毒性作用，对骨髓细胞有选择性抑制，但马利兰和恶性肿瘤之间的关系报导尚不多见，现报告1例慢性粒细胞白血病经服用马利兰缓解后合并鼻咽癌的病例如下。     

脾脏重度肿大型慢性粒细胞白血病67例临床治疗观察

脾脏重度肿大型成人慢性粒细胞白血病(慢粒)在临床治疗一直比较困难,常用药物马利兰、羟基脲治疗临床见效十分缓慢,1 991年始我们采用HA方案对脾脏重度肿大型成人慢粒进行诱导缓解,取得满意疗效.并与马利兰、羟基脲治疗的脾脏重度肿大型慢粒进行比较,15年积累病例67例,报告如下.     

MA方案治疗慢性粒细胞白血病疗效评价

米托蒽醌为合成的蒽环类抗肿瘤药物,能嵌入DNA和形成交叉链相连,对RNA合成也有抑制,为周期非特异性药物.现主要用于急性非淋巴细胞性白血病的治疗.慢性粒细胞性白血病经典治疗为羟基脲或马利兰,但对于较高白细胞数,有巨脾者常显效慢,临床多采用联合化疗治疗慢性粒细胞性白血病[1].1998年9月-2000年8月,我们用MA方案治疗此类患者6例,并以HA方案[2]和AA方案组为对照组,进行了治疗研究,现总结如下.     

慢性粒细胞白血病未维持治疗存活15年1例

慢性粒细胞白血病未维持治疗存活１５年１例刘心，刘陕西，邵文斌病例介绍男，５４岁。曾因低热、乏力伴左上腹包块２个月于１９７９年１月到西安市某医院就诊，经骨髓象检查确诊为慢性粒细胞白血病。给予马利兰口服，每日４ｍｇ～８ｍｇ，约三个月症状消失，血象基本正常...     

INF-α+低剂量阿糖胞苷治疗慢性粒细胞白血病疗效观察

慢性粒细胞白血病(CML)是起源于造血干细胞的恶性增殖性疾病,90%～95%CML患者可检测到Ph染色体和bcr/ab1基因.一般采用马利兰、羟基脲治疗.为探索治疗CML的新方法,我们观察自1997年5月试用INF-α+LDAra-C低剂量阿糖胞苷治疗32例CML患者,取得理想的疗效.现报道如下.     

羟基脲联合米托蒽醌治疗高白细胞急性白血病的疗效观察

我院自 1994年 12月至 2 0 0 0年 7月 ,采用羟基脲联合米托蒽醌为主的化疗方案治疗高白细胞急性白血病 18例 ,取得较好疗效 ,现报告如下。1　临床资料1.1　病例所有病例均为住院患者 ,经临床、血像、骨髓像、细胞化学染色确诊 ,部分病例经免疫单抗分型确诊 ,符合ＦＡＢ诊断标准。男性 11例 ,女性 7例 ,年龄 19～ 6 4岁 ,中位年龄 39.0岁。急性非淋巴细胞白血病 (ＡＮＬＬ ) 8例 ,其中Ｍ13例 ,Ｍ2 4例 ,Ｍ4 1例 ;急性淋巴细胞白血病 (ＡＬＬ ) 10例 ,包括慢性粒细胞白血病急淋变 1例 ,其中Ｌ16例 ,Ｌ2 4例。外周血白细胞计数 10 2×10 9/Ｌ～…     

慢性粒细胞白血病急性变患者骨髓细胞P-gp和bcl-2蛋白表达水平的研究

我们对 2 4例慢性粒细胞白血病急性变 (慢粒急变 )患者骨髓细胞多药耐药糖蛋白Ｐ -ｇｐ和ｂｃｌ -2蛋白表达水平进行了初步研究 ,现将结果报告如下。1　材料和方法1.1　临床资料慢性粒细胞性白血病急性变患者 2 4例 ,男性 16例 ,女性 8例 ,年龄 15～ 6 1岁 ,中位年龄 39岁 ,其中急性淋巴细胞白血病变 (慢粒急淋变 ) 8例 ,急性非淋巴细胞白血病变 (慢粒急非淋变 ) 16例 (Ｍ1型 3例 ,Ｍ2 型 5例 ,Ｍ4 型 2例 ,Ｍ5型 6例 )。对照组为 37例原发性急性白血病患者 ,其中急性淋巴细胞白血病(原发性急淋 ) 15例 ,急性非淋巴细胞白血病 (原发性急非淋…     

恶性胰岛细胞瘤术后肝转移介入治疗临床分析:附8例报道并文献复习

目的:探讨肝动脉化疗栓塞术治疗恶性胰岛细胞瘤外科术后肝转移患者的临床疗效。方法:回顾性分析在我科行介入治疗的8例恶性胰岛细胞瘤术后肝转移患者。原发灶位于胰颈部1例,胰体尾部7例。7例为肝脏多发转移,1例为肝内单一病灶。所有患者均接受1-6次肝动脉化疗栓塞术。结果:8例患者均获得随访,随访0.5-8年。其中部分缓解（PR）6例,稳定（SD）2例,进展（PD）0例。目前仍生存6例,最长已生存8年,死亡2例。1例伴有低血糖患者空腹血糖恢复正常水平,所有患者均出现程度不等的术后反应,但未出现严重并发症。结论:恶性胰岛细胞瘤外科术后肝转移患者行肝动脉化疗栓塞术安全,疗效确切。     

Adenosarcoma of uterus and ovary: a clinicopathologic study of two cases.

We report the clinical and pathologic features of two cases of adenosarcoma. Our first case occurred in the ovary of a 51-year-old woman with extensive pelvic involvement. She was treated vigorously with radiation and chemotherapy and at the present time almost 9 years later the patient is free of disease. This represents a case with one of the longest survival reported in the literature. Our second case occurred in a 37-year-old woman and was limited to the endometrium.     

Long-term survival in Ki-1 lymphoma

Three patients with histologic and immunologic features of Ki-1-positive large cell lymphoma, who experienced long-term survival, are presented. These three patients at 2, 28, and 49 years of age had adenopathy; all cases had been initially misdiagnosed as metastatic carcinoma or malignant histiocytosis. On subsequent review, they had sinusal and diffuse growth of large pleomorphic cells that were Ber-H2 (Ki-1; CD 30) positive. One case marked as a T-cell lymphoma with UCHL1, one case expressed T-cell and B-cell markers, and one case was negative for both T-cell and B-cell markers. All patients received chemotherapy, and two received local radiation. One patient was not treated until 9 years after initial diagnosis. Two patients had several recurrences, but there has been no evidence of lymphoma in any of the three patients for 63 to 301 months; overall survival time has ranged from 14 to 25 years. These cases are the longest reported survivors with Ki-1 lymphoma; 5 years was the longest survival time previously reported. It also is noteworthy that Ber-H2 and other lymphoid-associated antigens appear to be preserved in formalin-fixed, paraffin-embedded tissues for prolonged periods. This may allow retrospective studies to evaluate the natural history of Ki-1 lymphomas, as well as their spontaneous or treatment-induced regression.     

The effects of PS-K on long-term survival of uterine cervical cancer patients treated with radiation

The effects of PS-K on long-term survival of uterine cervical cancer patients treated with radiation was studied. The patients receiving PS-K were anxious about curability more or less at the time of completion of radiation therapy. Between 1977 and 1983, out of 96 patients with stage III, IV uterine cervical cancer treated with radiation, 27 were given PS-K as adjuvant therapy. The number of cases with PS-K administration were 15 (23%) out of 64 in stage IIIb, seven (37%) out of 19 in stage IVa and five (38%) out of 13 in stage IVb. Out of 27 patients administered PS-K, 19 were given the agent within three months after irradiation and the remaining eight after recognition of recurrence or metastasis. As a rule, PS-K was given orally, 3.0 g per day, intermittently in the pattern of two weeks per month. Judgement of the effects of PS-K was made in comparison with the survival rate of the patients with and without PS-K, and then by observation of the changes of the PPD skin test, ESR, appetite and body weight as early effectiveness of PS-K. The results were as follows. Obvious prolongation of survival was recognized in the patients with PS-K after irradiation. Namely, the cumulative five-year survival rates of stage IIIb were 65% and 49% with and without PS-K, respectively. Improvement by PS-K as early effectiveness was obtained in seven cases (37%) out of 19. The conditions necessary for long-term survival with PS-K were thought to be as follows: that the tumor almost disappears as a result of irradiation and that the condition of the host is superior to that of the tumor in the tumor-host relationship. The effectiveness of intermittent administration of PS-K was suggested.     

复发性鼻咽癌三维适形放射治疗的疗效分析

目的 分析复发性鼻咽癌三维适形放射治疗的疗效及影响疗效的因素.方法 56例复发性鼻咽癌接受三维适形放射治疗,鼻咽部剂量50～70Gy/36～52d(中位64Gy/44d).结果 全组病例随访3年以上.3年总生存率、无瘤生存率和鼻咽部局部控制率分别为48.2 %、44.6%和53.6%.复发间隔时间＞2年和复发临床分期T2期者,3年生存率和局部控制率高(P＜0.05);再程放疗剂量≥60Gy者,3年生存率和局部控制率优于＜60Gy.结论 三维适形放射治疗是复发性鼻咽癌有效的治疗手段,其复发间隔时间、复发临床分期和再程放疗剂量是影响预后的因素.     

食管癌性溃疡穿透纵隔的外科治疗——附16例报告

我科于1987年4月至1989年1月选择性对16例食管癌性溃疡穿透纵隔患者进行外科治疗,切除13例。经随访其1、3年生存率为92.3％(12/13)。33.3％(2/6),效果满意。本文讨论了食管癌性溃疡穿透纵隔的诊断标准,外科治疗的可行性、手术指征及手术操作要点。     

手术后放射治疗对局部中晚期食管癌患者预后的影响

目的探讨手术后放射治疗对局部中晚期食管癌患者预后的影响。方法 100例食管癌术后患者采用随机数字表法分为观察组和对照组,每组50例,分别进行术后放射治疗+化疗与单纯化疗。结果观察组中T3N0M0患者的1、2、3年生存率、局部复发率及远处转移率显著优于对照组T3N0M0患者(P<0.05)。两组患者(除T3N0M0患者外)远处转移率比较,差异无统计学意义(P>0.05)。两组患者白细胞下降发生率比较,差异有统计学意义(P<0.05)。结论术后放射治疗能够有效控制局部中晚期食管癌患者的局部复发,对T3N0M0患者的预后、局部复发率及远处转移率的影响更为明显。     

腓肠肌肌皮瓣在修复膝关节周围软组织肉瘤手术组织缺损中的应用

目的探讨应用腓肠肌肌皮瓣修复膝关节周围软组织肉瘤广泛切除术软组织缺损的临床疗效。方法回顾性分析2009年3月至2012年5月有完整随访资料的膝关节周围软组织肉瘤患者的临床资料。所有病例均行软组织肉瘤广泛切除手术,并依据不同部位及缺损范围设计应用腓肠肌肌皮瓣修复软组织肉瘤广泛切除后的软组织缺损。结果全组12例,手术过程顺利,腓肠肌肌皮瓣均顺利成活。术后随访3—39个月,平均15个月,全组病例无复发,其中1例滑膜肉瘤术后8个月出现肺转移,均无死亡。移植肌皮瓣质地好,皮肤色泽与受区相似,其中4例蒂部外观略显臃肿,其余外形及功能恢复均良好,膝关节屈伸无受限。肌皮瓣供区小腿运动功能无影响,供区瘢痕位置隐蔽,无明显挛缩。结论腓肠肌肌皮瓣血管恒定,术中操作简单,成活率高,是修复膝关节周围软组织肉瘤广泛切除术后软组织缺损的良好选择。     

Brain metastases from cholangiocarcinoma: a first case series in Thailand

Background: Brain metastasis from cholangiocarcinoma (CCA) is a rare but fatal event. To the best of ourknowledge, only few cases have been reported. Herein, we report the incident rate and a first case series of brainmetastases from CCA. Methods: Between January 2006 and December 2010 5,164 patients were treated atSrinagarind hospital, Khon Kaen University; of those, 8 patients developed brain metastasis. Here we reviewedclinical data and survival times. Results: The incident rate of brain metastases from CCA was 0.15%. The medianage of the patients was 60 years. Tumor subtypes were intrahepatic in 6 and hilar in 2 patients. All suffered fromsymptoms related to brain metastasis. Three patients were treated with whole-brain radiation therapy (WBRT),one of whom also underwent surgery. The median survival after the diagnosis of brain metastasis was 9.5 weeks(1-28 weeks). The longest survival observed in a patient in RPA class I with two brain lesions and received WBRT.Conclusion: This is a first case series of brain metastases from CCA with the incident rate of 0.15%. It is rareand associated with short survival time.     

Malignant melanoma of the oral cavity: diagnosis and treatment experience in a Mexican population

Oral malignant melanoma is uncommon, accounting for 1-8% of all malignant melanomas. All previous papers have reported small numbers of cases or have retrospectively reviewed case reports from the literature. The following case reports concern malignant melanoma of the oral cavity seen at the Instituto Nacional de Cancerología, Mexico City, during the period of 1982-96. Demographic, clinical and histopathological data were collected. Our 15 patients consisted of 6 males and 9 females. The mean age was 52.6 years (range: 35 to 80 years). The hard palate was the most common area affected with 11 cases (73%). At the time of the initial examination, a pigmented mass was apparent in 100% of the patients. All our surgical cases were treated with wide resection; 8 patients received adjuvant radiation, 4 were treated with surgery alone and 1 case received radiation and chemotherapy before the surgery. Local control of the primary lesion was possible in 14 of the 15 cases. Some patients received therapeutic or elective lymph node dissection. The median survival was 16.9 months (mean: 12.5 months). The 2- and 5-year survival rates were 26.6 and 6.6%, respectively.