放疗联合多西紫杉醇、顺铂同期及辅助化疗治疗局部晚期鼻咽癌的临床观察

目的观察多西紫杉醇联合顺铂同期放化及辅助化疗治疗局部晚期鼻咽癌的疗效及安全性。方法2008年1月～2009年12月共48例局部晚期鼻咽癌患者进入研究,放疗总剂量70～76Gy／35～38次,同期于第1、22、43天给予3周期多西紫杉醇＋DDP的同期化疗,放疗结束2周后,再给予3周期多西紫杉醇＋DDP的辅助化疗。结果中位随访25个月．66．7％的患者完成了全部6周期的化疗,75．0％的患者完成3个周期的同期化疗,70．8％的患者完成了3个周期的辅助化疗。2年局部控制率、总生存率和无进展生存率分别为89．6％、90．1％和77．8％。主要不良反应为中性粒细胞减少、粘膜炎和体重下降．但经过积极支持治疗,大多可完成治疗。结论初步结果表明对于局部晚期鼻咽癌患者,该方案依从性高,早期疗效较好．不良反应可耐受。     

紫杉醇联合顺铂同期放疗综合治疗局部中晚期鼻咽癌

目的评价紫杉醇联合顺铂同期放疗综合治疗局部中晚期鼻咽癌的疗效及不良反应。方法38例局部中晚期鼻咽癌患者行紫杉醇联合顺铂方案化疗,4周为1周期,共行2个周期。放疗在化疗第1个周期同期进行。结果38例入组患者同期放化疗毒性可耐受。总有效率(CR+PR)100%。三年随访,中位生存时间为33.9个月,中位局部无进展生存时间为32.5个月,1、2、3年局部无进展生存率分别为94.7%、86.8%、76.3%,1、2、3年总生存率分别为97.4%、84.2%、76.3%。结论紫杉醇联合顺铂同期放疗综合治疗局部中晚期鼻咽癌的疗效较好,毒副反应患者能耐受,安全可行。     

放疗同期DX方案化疗治疗晚期食管癌临床研究

目的探讨同期放化疗治疗局部晚期食管癌的临床疗效及毒性反应.方法将2002年1月～2004年6月56例局部晚期食管癌患者随机分为单纯放疗组和同期放化疗组,每组28例,两组放疗均采用常规分割放射治疗,总剂量60～70Gy,化疗采用Dx方案[多西紫杉醇37.5mg/m2,静脉滴注,第1、8d,希罗达2.0g/(m2·d),分2次口服,连用2w].21d化疗1周期,化疗共4个周期,与放疗同期进行2个周期,放疗结束后2个周期.结果同期放化疗组1、2,3年生存率分别为57.1%(16/28),42.8%(12/28),35.7%(10/28);单纯放疗组的1、2,3年生存率分别为53.4%(15/28),39.3%(11/28),14.3%(4/28).结论同期放化疗对局部晚期食管癌具有协同作用,可提高疗效,但毒副反应增加,值得进一步研究.     

三维适形放疗同期奈达铂化疗治疗局部晚期鼻咽癌近期疗效观察

目的：探讨三维适形放疗同期奈达铂化疗治疗局部晚期鼻咽癌近期疗效,为其临床治疗提供可参考依据。方法：连续收集100例入住本院诊断为局部晚期鼻咽癌患者,采用随机数字法平均分为A、B两组,A组患者给予三维适形放疗同期给予奈达铂化疗治疗措施,B组患者给予三维适形放疗同期给予顺铂化疗治疗措施,观察两组患者的近期临床疗效及相关并发症的发生。结果：A组患者完全缓解、部分缓解例数及总有效率明显高于B组患者,两组间比较差异有统计学意义（P〈0.05）。A组患者急性不良反应的发生率26.0%,慢性不良反应的发生率74.0%,B组患者急性不良反应的发生率32.0%,慢性不良反应的发生率76.0%,两组间比较差异无统计学意义（P〉0.05）。结论：三维适形放疗对治疗局部晚期鼻咽癌有较好的临床疗效,同时辅以予奈达铂化疗治疗临床疗效更好,且其不良反应的发生率未有明显增加,值得临床推广应用。     

单药多西他赛周疗联合3D-CRT治疗局部晚期非小细胞肺癌的疗效观察

目的观察单药多西他赛联合3D-CRT同步治疗局部晚期非小细胞肺癌的疗效、作用机制和耐受性。方法 60例均经病理证实为鳞癌的初治病人,临床分期ⅢA-ⅢB。随机分成两组:观察组:(3D-CRT同步多西他赛增敏+辅助化疗)共30例,与放疗同步,多西他赛静脉滴注(36mg/m2),每周1次,从放疗第1天开始,共6周,放疗结束后TP方案辅助化疗2周期;对照组:(3D-CRT+辅助化疗)共30例,放疗结束后TP方案辅助化疗4-6周期。结果近期疗效(CR+PR):观察组/对照组80%/66.7%。观察组/对照组1、2、3年局控率分别为90.0%/80.0%、80.0%∕53.0%7、0.0%∕40.0%;12、、3年生存率分别是90.0%∕80.0%、73.0%∕47.0%、60.0%∕33.3%。通过对单药多西他赛周疗联合3D-CRT治疗局部晚期非小细胞肺癌的疗效观察发现,近期疗效观察组优于对照组(P<0.05,有统计学意义);23、年局控率及生存率观察组均优于对照组,两组均有统计学意义(P<0.05)结论单药多西他赛周疗联合三维适形放疗同步治疗局部晚期非小细胞肺癌疗效较好,毒副反应可耐受,值得临床推广。     

超分割放疗+同步化疗与单纯常规分割放疗治疗局部晚期鼻咽癌的近期疗效分析

目的 探讨超分割放疗+同步化疗与单纯常规分割放疗治疗局部晚期鼻咽癌的近期疗效.方法 将40例局部晚期鼻咽癌患者随机分为两组:试验组(20例)为超分割放疗+同步化疗患者,采用每周连续5 d照射,2次/d,2次间隔6～8 h,1.2 Gy/次,总量为80 Gy/7周,放疗第1天开始行同步化疗,方案为紫杉醇90 mg d1、8、15静脉滴注(2～4 h),卡铂500mg d1静脉滴注,4周为1个周期,共化疗4～6个周期.对照组(20例)为单纯常规分割放疗患者,采用每周连续5 d照射,1次/d,2Gy/次,总量为70 Gy/7周.结果 试验组治疗有效率为80%(16/20),对照组为45%(9/20),两组有效率比较差异有统计学意义(P＜0.05).结论 治疗局部晚期鼻咽癌时,超分割放疗+同步化疗比单纯常规分割放疗可明显提高近期疗效.     

同步放化疗治疗局部晚期鼻咽癌的疗效观察

目的探讨同步放化疗治疗晚期鼻咽癌的疗效以及患者接受治疗后的耐受性。方法 75例局部晚期鼻咽癌患者随即分为两组,放化疗组37例和单纯放疗组38例。放化疗组采用放疗同步顺铂加氯尿嘧啶化疗,观察两组的临床疗效以及患者的不良反应情况。结果放化疗组总有效率是78.3%(29例),单纯放疗组总有效率是63.1%(24例),两者的差异具有统计学意义(P<0.05)。放化疗组3年生存率是59.4%(22例),单纯放疗组3年生存率是39.4%(15例),两者的差异同样具有统计学意义(P<0.05)。放化疗组的患者不良反应高于单纯放疗组,但经过对症处理后患者均可耐受。结论同步放化疗可以提高晚期鼻咽癌患者的局部控制率和生存率,患者可以耐受不良反应,值得临床推广应用。     

艾迪注射液联合放化疗治疗局部晚期鼻咽癌的临床观察

目的观察艾迪注射液联合放化疗治疗局部晚期鼻咽癌的疗效和不良反应。方法 48例局部晚期鼻咽癌患者均采用艾迪注射液＋调强适形放疗＋化疗同步进行。结果患者的1、2、3、4年总生存率分别为100%、92.7%、85%和79%,1、2、3、4年无疾病进展生存率分别为89%、84.5%、74.7%和61%。主要不良反应为黏膜反应、白细胞减少、血小板下降、消化道反应,经对症处理后患者均可耐受。结论应用艾迪注射液联合调强适形放疗加同步化疗治疗中晚期鼻咽癌有较好疗效,可减轻放化疗不良反应,提高患者的生活质量。     

多西他赛联合顺铂治疗晚期鼻咽癌临床效果观察

目的：探讨多西他赛联合顺铂治疗晚期鼻咽癌的临床效果。方法：选取晚期鼻咽癌患者89例,随机分为两组,其中对照组41例,观察组48例。对照组给予单纯放射治疗;观察组在对照组基础上给予多西他赛联合顺铂同期化疗。对两组近期治疗效果及远期生存率、复发率和远处转移率进行评价和比较。结果：观察组完全缓解率为83.33%,三年生存率为87.50%,明显高于对照组48.78%和70.73%;观察组3年复发率和远处转移率均为2.08%,明显低于对照组的9.76%。两组差异有统计学意义（P〈0.05）。结论：对晚期鼻咽癌患者在放疗基础上实施多西他赛联合顺铂的化疗,可以有效提高患者的治疗效果,改善预后,具有积极的临床意义。     

联合多西紫杉醇同步化疗对鼻咽癌(Ⅲ、ⅣA期)放疗的疗效分析

目的观察了解联合多西紫杉醇同步化疗对局部鼻咽癌(Ⅲ、ⅣA期)实际疗效和不良反应临床情况。方法将鼻咽癌患者随机分为两组对比治疗。结果同步化疗组和单纯放疗组患者局部鼻咽病灶消退率分别为93.6%和72.7%。结论同步化疗可以增加局部中晚期鼻咽癌病灶和颈部转移淋巴结的消退率。     

Concurrent chemoradiotherapy for T3–4 and N0–1 nasopharyngeal cancer: Asian multicenter trial of the Forum for Nuclear Cooperation in Asia

The aim of this study was to evaluate the toxicity and efficacy of radiotherapy concurrent with weekly cisplatin for T3–4 and N0–1 nasopharyngeal cancer. Between 2005 and 2010, 70 patients with nasopharyngeal cancer (T3–4 N0–1 M0, World Health Organization Type 2–3) from Vietnam, Indonesia, Malaysia and Thailand were registered. Patients were treated with 2D radiotherapy concurrent with weekly cisplatin (30 mg/m²). Neither adjuvant nor induction chemotherapy was given. Ninety-three percent of the patients completed at least four cycles of weekly cisplatin during radiotherapy. The median total doses for the primary tumor and positive lymph nodes were 70 and 66 Gy, respectively. The median overall treatment time of concurrent chemoradiotherapy was 52 days. No treatment-related deaths occurred. Grade 3–4 acute toxicities of mucositis, nausea/vomiting and leukopenia were observed in 34%, 4% and 4% of patients, respectively. With a median follow-up time of 52 months for the 40 surviving patients, the 3-year local control, locoregional tumor control, distant metastasis–free survival and overall survival rates were 80%, 75%, 74% and 80%, respectively. In conclusion, the current results illustrate that our concurrent chemoradiotherapy regimen was feasible, but disease control remained insufficient. Further research is encouraged in order to improve clinical outcomes.     

Analysis of simultaneous modulated accelerated radiotherapy (SMART) for nasopharyngeal carcinomas

The purpose of this study was to analyze the clinical outcomes of simultaneous modulated accelerated radiotherapy (SMART) in patients with nasopharyngeal carcinoma (NPC). A total of 97 patients who underwent SMART for NPC between August 2005 and November 2011 were evaluated. The prescribed dose was 69.9 Gy/30 fractions at 2.33 Gy/fraction to the primary gross tumor volume (PGTV) including the nasopharynx gross target volume and the positive neck lymph nodes, and 60 Gy/30 fraction at 2.0 Gy/fraction to the PCTV1; 54 Gy/30 fractions at 1.8 Gy/fraction was given to the PCTV2. Among 59 patients with local advanced disease, 31 patients received concurrent chemoradiotherapy (chemo-RT) with a regimen consisting of 135 mg/m² paclitaxel on Day 1 and 25 mg/m² cisplatin on Days 1–3. The median follow-up period was 42 months. The local control rate (LCR), distant metastases-free survival (DMFS) and overall survival (OS) rates were 93.3%, 90.3% and 91.6% at 3 years, and 87.6%, 87.9% and 85.7% at 5 years, respectively. There was no significant difference in outcome with respect to these three indicators for Stage III and IV disease treated with/without concurrent chemoradiotherapy (P > 0.05). Acute toxicities included Grade 3 mucositis, skin desquamation, and leucopenia, which occurred in 78 (80.4%), 8 (8.2%), and 45 (46.4%) patients, respectively. No patient had a Grade 3–4 late toxicity. SMART was associated with a favorable outcome for NPC with acceptable toxicity. The local-regional control was excellent but distant metastasis remains the main risk. The combination of SMART and chemotherapy needs to be optimized through further studies to enhance outcomes for locally advanced diseases.     

消癌平注射液联合放化疗在局部中晚期鼻咽癌治疗中的疗效观察

目的：观察消癌平注射液联合诱导化疗及同步放化疗在局部中晚期鼻咽癌治疗中的疗效观察。方法：选取局部中晚期鼻咽癌患者60例,按随机数字表法分为治疗组（消癌平组联合放化疗组）30例和对照组（单纯放化疗组）30例,两组治疗前均未行过化疗、放疗、免疫治疗及中医中药治疗等。观察治疗结束后两组肿瘤病灶变化情况、皮肤及口腔黏膜反应、骨髓抑制程度和肝肾功能情况。结果：治疗结束12个月后复查,治疗组完全缓解率高于对照组,差异有统计学意义（P〈0.05）;且骨髓抑制较对照组轻（P〈0.05）,其他毒副评价相当。结论：消癌平注射液联合放化疗治疗中晚期鼻咽癌具有增效、减毒作用,值得进一步研究证实。     

三维适形放疗同步TP方案治疗中晚期宫颈癌的临床观察

目的观察三维适形放疗同步TP方案治疗中晚期宫颈癌的的临床疗效。方法将75例中晚期宫颈癌患者随机分为治疗组和对照组,治疗组38例,接受三维适形放疗同步TP(多西紫杉醇+顺铂)方案化疗;对照组37例,接受放疗。结果治疗组的有效率为94.7%,明显高于对照组的70.3%,差异有统计学意义(P﹤0.05)。随访2年,治疗组和对照组的局部复发率分别为7.9%和29.7%,远处转移率分别为10.5%和35.1%,差异均有统计学意义(P﹤0.05)。两组的1、2年生存率分别为92.1%和70.3%,84.2%和62.2%,差异有统计学意义(P﹤0.05)。治疗组的胃肠道副反应、骨髓抑制、放射性直肠炎及放射性膀胱炎的发生率略高于对照组,但差异无统计学意义(P﹥0.05)。结论对于中晚期宫颈癌患者,同步放化疗与单纯放疗相比可降低局部复发率和远处转移率,提高1、2年生存率,是一种安全有效的辅助治疗方法。     

Impact of incomplete plan to treatment results of concurrent weekly cisplatin and radiotherapy in locally advanced cervical cancer

To evaluate the efficacy of incomplete treatment protocols of cisplatin in concurrent chemoradiation for locally advanced cervical carcinoma. This retrospective study was performed in 165 consecutively treated patients with locally advanced cervical cancer who received a weekly cisplatin regimen. The number of weekly cisplatin cycles of each patient was recorded and used to discriminate between patients. Local control, disease free survival, distant metastasis-free survival, and toxicities were calculated using the software package SPSS version 15.0. Ninety-two patients (55%) completed the planned protocol of six cycles of weekly cisplatin. With the median follow-up time of 38.2 months, the 3-year local control rate differed significantly in the two patient groups (95.4% of 6 cycles versus 84.8% of < 6 cycles; p = 0.028). No statistical significance was observed for disease-free survival (74.6% versus 74.5%; p = 0.22) and distant metastasis-free survival (76.5% vs. 75.7%; p = 0.88). In conclusion, the plan completion of concurrent cisplatin with radiotherapy was responsible for better local control. However, differences in disease-free survival and distant metastasis-free survival were not statistical significant.     

复方苦参联合同步放化疗治疗局部晚期鼻咽癌的临床研究

目的 比较复方苦参注射液联合同步放化疗与单纯同步放化疗治疗局部晚期鼻咽癌的的近期疗效和毒副作用.方法 将70例经病理学证实为局部晚期鼻咽癌（按92年福州分期Ⅲ、ⅣA期的初治鼻咽癌）患者随机分为治疗组即复方苦参组（复方苦参联合同步放化疗）和对照组（同步放化疗）各35例.两组同步放化疗均采用相同的常规分割根治性二维放疗和单药顺铂同步化疗（顺铂 20mg/m2,静脉应用,每周一次,共用5周）.复方苦参组中采用复方苦参注射液15 ml＋5%葡萄糖注射液250 ml,d1～d14.治疗期间每周观察口咽黏膜反应、面颈部皮肤反应、骨髓抑制等副反应.同步放化疗结束后2周后对患者进行体力状况评分.放疗后3个月,12个月评价有效率（CR＋PR）.结果 复方苦参组患者的体力状况评分（KPS评分）优于对照组.口咽黏膜反应、面颈部皮肤反应、骨髓抑制等不良反应在复方苦参组均较对照组轻（P〈0.05）.复方苦参组有效率高于对照组（85.71% vs 71.42%）,差别有统计学意义（P=0.0375）.结论 复方苦参注射液联合同步放化疗治疗局部晚期鼻咽癌能减轻同步放化疗的副反应,并提高有效率.     

替吉奥联合多西他赛治疗晚期胃癌的疗效观察

目的 观察评价替吉奥联合多两他赛化疗治疗晚期胃癌的近期疗效和毒副反应.方法 选择我院2008年1月-2013年6月收治的24例无法手术及放疗的晚期胃癌患者,给予替吉奥40 mgbid/m2d1-14,多西他赛40 mg/m2d1联合化疗,每21 d为1个周期,每完成2个周期评价疗效.每个周期化疗后评价毒副反应.结果 24例总有效率为41.7％,疾病控制率70.8％.主要毒副反应为骨髓抑制、胃肠道反应等,均为轻、到中度.结论 替吉奥联合多西他赛治疗晚期胃癌疗效确切,毒副反应较低,值得临床推广及进一步研究.