沙利度胺联合化疗治疗NSCLC患者的临床疗效和安全性观察

目的探究沙利度胺与化疗联合治疗非小细胞肺癌(NSCLC)患者的有效性与安全性。方法选取2012年3月至2013年3月在我院治疗的NSCLC患者88例,采用随机数字表法将其分为A、B两组,每组44例。A组患者给予沙利度胺联合化疗治疗,B组仅给予化疗治疗。观察并比较两组患者的疗效与不良反应情况。结果 A组的疾病总缓解率为54.55%,显著高于B组的31.82%,差异具有统计学意义(P<0.05)。A组治疗期间以白细胞减少为主要不良反应,发生率为84.09%,与B组的72.73%相比,差异无统计学意义(χ2=1.678,P>0.05)。结论沙利度胺联合化疗用于治疗NSCLC患者,可有效提高临床治疗缓解率,不良反应没有明显增加,安全性较好,值得临床推广使用。     

沙利度胺用于预防化疗病人恶心、呕吐的临床疗效观察

目的观察沙利度胺(Thalidomide反应停)用于缓解化疗病人恶心、呕吐的临床疗效。方法将53例恶性肿瘤患者(包括乳腺癌、肺癌、大肠癌、胃癌、胰腺癌、软组织肉瘤患者),随机分为2组:试验组25例,采用各科肿瘤传统化疗方案与沙利度胺和5-HT3受体拮抗剂(托烷司琼剂)联合治疗;对照组28例,采用传统化疗方案只与5-HT3受体拮抗剂联合治疗。结果试验组与对照组病例临床资料相比差异无统计学意义。两组的客观有效率差异无统计学意义(P﹥0.05)。试验组对于恶心、呕吐的完全缓解率和有效率均高于对照组(P﹤0.05)。结论沙利度胺(反应停)联合5-HT3受体拮抗剂用于治疗化疗过程中病人的恶心、呕吐比单用5-HT3受体拮剂缓解率更高,起效更快,可提高化疗病人的依从性和生活质量。     

沙利度胺联合VAD方案治疗多发性骨髓瘤疗效观察

观察沙利度胺(反应停)联合VAD方案治疗多发性骨髓瘤的临床效果。方法:多发骨髓瘤病例12例,采用沙利度胺联合VAD方案治疗,其中VCR0.4mg/d,持续静脉滴注12h～24h,d1-4,阿霉素10mg/d,持续静脉滴注12h～24h,d1-4,地塞米松20mg/次,q12h,静脉滴注,d1-4d9-12d17-20,同时口服沙利度胺,起始量200mg/d,根据患者耐受情况,逐渐加量,最高可达800mg/d,一个月为一疗程。结果:12例患者,CR1例,PR4例,明显进步5例,总有效率达83%。结论沙利度胺联合VAD治疗多发性骨髓瘤疗效高、副作用少,值得推广。     

沙利度胺治疗恶性血液病的临床观察

目的 分析联合应用沙利度胺(反应停)对难治性或不能耐受化疗的恶性血液病患者的疗效.方法 对38例常规治疗方案不能缓解或无法耐受常规治疗的恶性血液病患者加用沙利度胺,观察其疗效.结果 骨髓增生异常综合征治疗有效率83.3%,多发性骨髓瘤有效率68.8%,急性髓细胞白血病有效率50.0%,慢性骨髓增生性疾病有效率66.7%.结论 联合应用沙利度胺可提高难治性或不能耐受化疗的恶性血液病的疗效.     

沙利度胺治疗恶性血液病的临床观察

目的分析联合应用沙利度胺（反应停）对难治性或不能耐受化疗的恶性血液病患者的疗效。方法对38例常规治疗方案不能缓解或无法耐受常规治疗的恶性血液病患者加用沙利度胺，观察其疗效。结果骨髓增生异常综合征治疗有效率83．3％，多发性骨髓瘤有效率68．8％，急性髓细胞白血病有效率50．0％，慢性骨髓增生性疾病有效率66．7％。结论联合应用沙利度胺可提高难治性或不能耐受化疗的恶性血液病的疗效。     

沙利度胺联合VAD方案治疗多发性骨髓瘤

目的：评价沙利度胺治疗多发性骨髓瘤的治疗效果。方法：采用配对观察的方法观察沙利度胺治疗多发性骨髓瘤的效果。将骨髓瘤患者随机分成A、B两组：A组采用沙利度胺＋VAD,使用剂量：沙利度胺200mg,口服d1～21＋VAD方案（长春新碱0．5mg／d,d1-4、阿霉素10mg／d,d1-4、地塞米松40mg／d,d1-4,9～12,17—20）。B组只采用VAD方案,方案同上。结果：A组治疗有效率明显高于B组。结论：沙利度胺对多发性骨髓瘤治疗有明显的促进作用。     

沙利度胺联合替吉奥、奥沙利铂化疗方案对晚期胃癌患者治疗效果评价

目的 探讨沙利度胺联合替吉奥、奥沙利铂(SOX)化疗方案对晚期胃癌患者肿瘤标志物水平及不良反应的影响.方法 选取某医院2015年8月-2018年8月收治的50例晚期胃癌患者,根据随机数表法分为对照组和观察组,每组各25例.对照组给予沙利度胺药物治疗,观察组在此基础上加用SOX化疗方案治疗.两组均连续治疗4周期,每周期为...     

沙利度胺联合常规化疗方案治疗急性白血病的临床疗效及对患者免疫水平的影响

目的 探讨沙利度胺联合常规化疗方案治疗急性白血病的临床疗效及对患者免疫水平的影响。方法 将60例急性白血病患者随机分为研究组(n=30,沙利度胺+常规化疗)和常规组(n=30,常规化疗),比较两组的疾病缓解率、免疫水平及不良反应情况。结果 研究组疾病缓解率为93.33%,高于常规组的70.00%(P<0.05)。治疗后,两组的CD₃⁺、CD₄⁺、CD₄⁺CD₈⁺、NK细胞水平均升高,CD₄⁺CD25⁺均降低,且研究组的CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺、NK细胞水平高于常规组,CD₄⁺CD⁺_...     

乳腺癌患者细胞免疫功能的检测

研究表明机体的免疫功能随着肿瘤的不断生长而进行性下降 ,特别是晚期带瘤机体的各种特异性和非特异性的细胞与体液免疫功能均受到显著的抑制 ,肿瘤的发生发展与机体免疫低下互为恶性因果关系 ,大量的研究证实Ｔ淋巴细胞介导的细胞免疫在机体排斥肿瘤方面起重要作用。本研究旨在探讨乳腺癌患者细胞免疫功能的变化及与乳腺癌发展的关系 ,为临床综合治疗乳腺癌提供参考。1　材料与方法1·1　病例选择　选择 1996年 5月至 2 0 0 0年 6月我科收治的女性Ⅰ、Ⅱ期乳腺癌患者 6 2例 (年龄在 2 8～ 72岁 ,平均年龄 4 7 4岁 ) ,Ⅲ、Ⅳ期乳腺癌患者 6 …     

小剂量沙利度胺联合柳氮磺吡啶治疗强直性脊柱炎

[目的]观察小剂量沙利度胺联合柳氮磺吡啶治疗强直性脊柱炎(AS)的临床疗效。[方法]2008年10月~2010年10月门诊及住院的AS患者74例,随机分为治疗组和对照组,对照组36例,给予双氯芬酸钠25mg,3次/日,柳氮磺吡啶1.0.2次/日,治疗组38例,在对照组治疗方案的基础上,给予沙利度胺,起始量每次50mg,1次/晚,10d后100mg,1次/晚,疗程半年。治疗前后观察:活动性指数(BASDAI)、功能性指数(BASFI)、晨僵时间、扩胸度、指地距、枕壁距、Schober试验、血沉、C反应蛋白及不良反应。[结果]治疗组全部病例治疗半年后,各项指标均有不同程度的改善,有效率95%,对照组有效率78%,两组改善情况差异有统计学意义(P﹤0.05)。常见不良反应为:困倦、上腹部不适及轻度转氨酶升高。[结论]小剂量沙利度胺联合柳氮磺吡啶治疗AS,效果显著,不良反应轻。     

Case study of a chaplain's spiritual care for a patient with advanced metastatic breast cancer

The case study seeks to describe an oncology chaplain's pastoral relationship with a 64-year-old woman with advanced metastatic breast cancer. The patient's distress was complicated by a history of anxiety and other chronic medical conditions. Approximately 16 pastoral encounters occurred during the last year of the patient's life. The patient, chaplain, and the pastoral conversations are presented as well as a retrospective assessment of them. The chaplain's interventions were appropriate for the patient's spiritual needs, particularly in regard to her fear of death, loneliness, grief that her life was "too short" and estrangement from her inherited faith tradition, with observable benefits for the patient. The oncology chaplain has a distinctive role in the healthcare team as one who can meet the patient at the point of their spiritual need, provide appropriate interventions and, thereby, ameliorate the distress, particularly in regard to death anxiety, peace of mind, and issues of meaning.     

Eribulin for heavily pre-treated metastatic breast cancer patients

AIM: To discuss treatment with eribulin in clinical practice outside a clinical trial.METHODS: Archives of patients treated for metastatic breast cancer were reviewed and 21 patients treated with the new chemotherapeutic eribulin mesylate, a synthetic analog of a natural marine product, were identified. Information on patients' characteristics and treatment outcomes was extracted. Treatment with eribulin mesylate was initiated at the recommended dose of 1.4 mg/m2 on days 1 and 8 of a 21-day cycle in 17 patients and at a decreased dose of 1.1 mg/m2 on days 1 and 8 of a 21-day cycle in 4 patients due to comorbidities and frailty. Efficacy of the drug was evaluated using the revised Response Evaluation Criteria in Solid Tumors criteria. Progression-Free Survival and overall survival(OS) were calculated using the Kaplan-Meier method starting from the date of eribulin therapy initiation to the date of disease progression documentation or death, respectively.RESULTS: The median age of patients at the time of eribulin mesylate treatment was 53 years(range 34-75). Sixteen patients had estrogen receptor(ER) and/or partial response(PR) positive disease and 5 had ER/PR negative disease(all triple negative). Eight patients had received 2 or 3 previous lines of chemotherapyfor metastatic disease and 13 patients had received 4 or more lines of treatment. The median number of cycles of eribulin received was 3(range 1-16 years). All patients, except one, discontinued treatment due to progressive disease and one patient due to adverse effects. Six patients had a dose reduction due to side effects. All patients had progressed at the time of the report with a median time to progression of 3 mo(range 1 to 14 mo). Fifteen patients had died with a median OS of 7 mo(range 1-18 mo). Six patients were alive with a median follow-up of 13.5 mo(range 7 to 19 mo).CONCLUSION: This series of patients confirms the activity of eribulin in a heavily pre-treated metastatic breast cancer population consistent with phase Ⅱ and Ⅲ trials.     

Systemic treatment of metastatic breast cancer

This article reviews recent advances in the treatment of metastatic breast cancer, in particular the results of randomized controlled phase III clinical trials. These have led to the evidence-based introduction of several new drugs including aromatase inhibitors, taxanes and bisphosphonates, some of which have been shown to impact on overall survival.     

Role of surgery in metastatic breast cancer

Breast cancer is the most common malignant tumor in Mexican women and very often patients present with advanced stages. Patients with metastatic breast cancer have limited therapeutic options and the mainstay of treatment in this disease stage is systemic chemotherapy Traditionally, the role of surgery in this context is limited to symptom palliation. The increase in efficiency of chemotherapy drugs and the new endocrine and molecular targeted therapy has prolonged the life expectancy of this group of patients and has expanded surgical indications beyond palliation. Some recent institutional reports suggest increasing survival of patients who undergo resection of limited metastatic disease. On another hand, there are reports of survival benefit when the primary tumor is removed even in presence of metastatic disease. We conducted a systematic review of the literature with the objective to analyze the role of surgery in the multidisciplinary management of metastatic breast cancer in order to improve the prognosis of this increasing group of patients.     

多西他赛联合卡培他滨治疗蒽环类化疗失败复发转移性乳腺癌临床观察

目的近年来蒽环类化疗失败复发转移性乳腺癌现象时常发生,将对患者造成更加严重的不良影响,需要采取良好的措施进行治疗。本研究探讨多西他赛联合卡培他滨治疗蒽环类化疗失败复发转移性乳腺癌的临床疗效。方法选取2018-02-01-2019-02-01许昌市人民医院收治的80例蒽环类化疗失败复发转移性乳腺癌患者为研究对象,依据临床采取的治疗方式选择对照组与观察组,各40例。对照组采用多西他赛联合顺铂治疗,观察组采用多西他赛联合卡培他滨治疗。观察两组患者的总缓解率及不良反应。结果观察组总缓解率为92.50%,高于对照组的72.50%,差异有统计学意义,χ~2=5.541,P=0.019;观察组不良反应发生率为15.00%,低于对照组的42.50%,差异有统计学意义,χ~2=7.384,P=0.007。结论多西他赛联合卡培他滨治疗蒽环类化疗失败复发转移性乳腺癌具有较好的临床效果,且不良反应发生率较低。     

乳腺癌围手术期抗菌药物应用的临床研究

目的探讨乳腺癌围手术期不使用抗菌药物对患者术后手术部位感染(SSI)的影响。方法回顾性分析2011年1月-2012年12月甲状腺乳腺外科收治的乳腺癌手术患者411例,将其分为对照组202例、研究组209例,对照组围手术期预防性使用抗菌药物,研究组围手术期不使用抗菌药物,观察两组患者SSI发生率,并对SSI发生及相关因素进行分析,数据采用SPSS13.0统计软件进行处理。结果 411例乳腺癌手术患者术后发生SSI2例,发生率为0.48%,对照组患者SSI发生率0.49%,研究组为0.48%,两组比较差异无统计学意义,证实乳腺癌术后SSI与是否应用抗菌药物无关;两组SSI患者在糖尿病、新辅助化疗、高龄等相关因素方面比较,差异无统计学意义;进一步分析发现,2例SSI均与术后皮下血肿及皮瓣坏死有关。结论乳腺癌术后SSI发生率与年龄、肥胖、糖尿病、术后创面血肿及血清肿等高危因素有关,与预防性使用抗菌药物无关,乳腺癌围手术期不使用抗菌药物并不增加SSI发生率,同时可以减少医疗费用,可以避免使用抗菌药物带来二次感染、耐药等问题,值得临床推广应用。