儿童阴道横纹肌肉瘤60Co高剂量率三维后装治疗应用价值研究

目的 探讨⁶⁰Co高剂量率三维后装在儿童阴道横纹肌肉瘤放疗中的应用流程,并从剂量学角度分析可行性。方法 选取5例已行儿童阴道横纹肌肉瘤放疗患儿CT定位图像,分别设计3种治疗计划:计划A为3DCRT外照射,计划B为后装治疗,计划C为后装治疗联合外照射。根据EQD2评估CTV和OAR剂量学参数并单因素方差分析。结果 与计划A相比,计划C的CTV的D₉₀、D₅₀、D_mean更高(P=0.00),直肠、膀胱和股骨头剂量低,卵巢剂量略高(P=0.00)。与计划B相比,计划C的CTV 的D₉₀更高,D₅₀、D_mean较低,卵巢剂量较低,直肠、膀胱和股骨头剂量略高。计划B的直肠、膀胱D_{2 cm³}最低。结论 儿童阴道横纹肌肉瘤的放疗需根据原发肿瘤位置及手术后是否残留选择合适的治疗方式。CT引导的⁶⁰Co高剂量率三维后装治疗方式流程简单快捷,患儿耐受性好,靶区剂量高,正常组织保护好。     

经食管床食管胃弓上器械吻合治疗食管癌

目的总结食管癌切除手术中应用吻合器行经食管床食管胃弓上器械吻合的临床经验.方法全组食管癌46例,其中食管胸中段癌32例,胸下段癌11例,胸上段癌3例.全部经左胸后外侧切口行食管癌切除,术中采用国产WGW-Ⅱ型消化道吻合器,行经食管床食管胃弓上吻合.结果全组手术吻合顺利,无术后死亡、吻合口瘘及明显吻合口狭窄.结论经食管床食管胃弓上器械吻合治疗食管癌具有扩大切除范围、降低术后并发症的优点,值得推广.     

Neoplastic transformation of human diploid fibroblasts (KMST-6) by treatment with 60Co gamma rays

Normal fibroblasts (KMS-6) derived from a human embryo were transformed in culture into neoplastic cells (KMST-6) by repeated treatment with 60Co gamma ray irradiation. Repeated treatment was necessary to obtain transformation. Control normal cells exhibited normal karyotype (46, XX) and stopped dividing due to cellular ageing at the 40th passage. The transformed cells are presently growing indefinitely (140th passage) and exhibit prominent karyologic aberrations, both numerical and structural. These 2 characteristics, indefinite growth and abnormal karyotype, are thought to be the most important parameters for neoplastic transformation of human fibroblasts. Other indispensable parameters are the presence of active mitotic figures on confluent cell sheets and colony-type morphology. Transformed cells grow into colonies with relatively smooth edges, while normal fibroblasts form colonies with jagged edges, due to the protrusion of growing fibroblasts. Other parameters, such as elevated plating efficiency, enhanced colony formation in soft agar, low serum requirement for growth, high saturation density, and acquisition of transplantability, are not reliable in the early stages of transformation. These parameters probably appear at rather later stages of transformation following several cell divisions. Among other characteristics, the transformed KMST-6 cells exhibit a B-type isozyme pattern of glucose-6-phosphate dehydrogenase, lactate-dehydrogenase isozyme pattern of human origin, no evidence of viral infection and no production of C-type virus particles.     

放疗同时多因子介入治疗60例晚期癌症的随机研究

目的探索晚期癌症的治疗方法。方法１９９６年１月～１９９７年３月,将６０例预期生存仅３～６个月的晚期癌症患者随机分成两组：（１）综合治疗组：放疗的同时用化疗药物、免疫反应修饰剂和中药制剂等多因子介入治疗;（２）对照组：单用放疗。两组放疗方法相同,腹腔肿块照射ＤＴ５０Ｇｙ,２５次／３５天,其他肿块照射ＤＴ６０Ｇｙ,３０次／４２天。结果综合治疗组有效率、平均缓解期、中位生存期和１年生存率分别为９３．３％、７．４个月、１１个月和４６．７％,对照组分别为６３．３％、４．７个月、６．５个月和６．７％,两组差异均有显著性（Ｐ＜０．０１）。结论综合治疗可有效延长晚期癌症患者生存期,并明显改善其生存质量。     

乳腺癌外科治疗的几点思考

 随着人们对乳腺癌认识的改变，乳腺癌的外科治疗出现了很大的变化。手术切除范围有缩小的趋势，出现了保留乳房和前哨淋巴结活检等个体化治疗。新的活检技术、新辅助化疗、微创治疗和一期乳房重建等诊治措施的出现给乳腺癌外科治疗提供了新的思路，同时也出现了新的争议。     

Fast neutron teletherapy in advanced epidermoid head and neck cancer. A review

An extensive review of clinical studies employing fast neutron teletherapy for advanced epidermoid carcinomas of the head and neck is presented. Head and neck tumors have represented an excellent study site because of their accessibility to physical examination for measurement of tumor response, and because early neutron beams have had poor depth dose characteristics, making the treatment of more deeply seated tumors technically difficult. A summary of the major trials comparing neutron and mixed-beam (combination neutron and photon) therapy with conventional therapy indicates no conclusive evidence of improvement in local control or survival rates for the experimental arms. Exceptions to this are the Hammersmith experience and the slightly higher lymph node control rates seen in two studies. An evaluation of toxicity indicates that with the new generation of cyclotrons, complication rates may approach parity with those of photon linear accelerators.