36例恶性纤维组织细胞瘤的术后放疗临床疗效分析

目的探讨恶性纤维组织细胞瘤手术切除 放射治疗的临床疗效。方法对36例恶性纤维组织细胞瘤患者行手术切除 放射治疗。结果5年单纯局部复发率27.78%(10/36);单纯远处转移率13.89%(5/36);局部复发合并远处转移8.33%(3/36);1、3、5年生存率分别为97.22%(35/36)、75.00%(27/36)、63.89%(23/36)。结论恶性纤维组织细胞瘤手术切除 放射治疗的疗效较好,值得进一步深入研究。     

皮下埋植式动脉化疗治疗骨恶性纤维组织细胞瘤的临床观察

目的观察骨恶性纤维组织细胞瘤（MFH-B）采用皮下埋植式动脉化疗泵的治疗效果。方法2004年4月～2008年5月共治疗5例骨恶性纤维组织细胞瘤患者，发病部位髂骨1例，股骨3例，胫骨1例；术前经皮下埋植式给药装置（化疗泵）行表阿霉素、顺铂导向性灌注3～5次，联合咖啡因或去甲斑蝥素治疗，化疗后通过临床及影像学观察有明显改变后进行保肢手术。结果4例患者化疗后疼痛完全缓解，1例明显缓解，且病变均有明显影像学改变，术后病理显示5例均有中重度的化疗反应，平均随访26个月，肺转移1例死亡，其余4例无复发和转移。结论皮下埋植式动脉化疗治疗MFH—B具有良好效果，化疗后的影像学改变显著，化疗后的肿瘤细胞广泛坏死，病理改变明显。     

恶性纤维组织细胞瘤25例疗效分析

目的探讨恶性纤维组织细胞瘤综合治疗的疗效.方法25例分别行广泛性、根治性切除及截肢技术,术后辅助放、化疗.观察复发率、转移率及2年、3年、5年生存率.结果术后复发率为64%(16/25),转移率为44%(11/25);2年、3年及5年生存率分别为60%、44%,12%.结论广泛性、根治性切除,术后辅助放、化疗是理想的治疗方法,首次切除是否彻底是影响预后的关键因素.     

软组织恶性纤维组织细胞瘤化疗的临床观察

目的 观察软组织恶性纤维组织细胞瘤动脉灌注化疗的疗效.方法 44例软组织恶性纤维组织细胞瘤,采用皮下埋植式动脉介入化疗系统,用阿霉素和顺铂联合咖啡因、去甲斑蝥素治疗,治疗后随访32个月.结果 本组病变影像改变PR 18例(56.3%).化疗后手术病理中重度以上化疗反应30例(71.4%).平均随访32个月,术后无肿瘤局部复发.肺转移3例,2例死亡.结论 软组织恶性纤维组织细胞瘤的治疗可以选择动脉灌注化疗,以化疗后手术切除的肿瘤病理改变作为重要的预后评价标准.     

32例头颈部恶性纤维组织细胞瘤的临床治疗及疗效分析

 目的　分析头颈部恶性纤维组织细胞瘤的治疗及临床特征。方法　复习 3 2例头颈部恶性纤维组织细胞瘤的病历 ,其中误诊为鼻息肉 2例、1例因颈部转移性肿块误诊为鼻咽癌、1例发生于眼眶而误诊为上颌窦恶性肿瘤侵犯。本组单纯手术 1 1例 ,单纯放疗 9例 ,手术加放疗 1 2例。结果　全组总的 5年生存率为 3 7.5 %。其中单纯手术 3 6.4% (4 /1 1 ) ;单纯放疗 3 3 .3 % (3 /9) ;手术加放疗 41 .7% (5 /1 2 )。结论　本病较易误诊 ,手术加放疗的预后相对较好。     

恶性纤维组织细胞瘤治疗及预后的研究现状

恶性纤维组织细胞瘤(MFH)是最常见的软组织肉瘤,常发生于四肢软组织,其治疗趋势为以手术为主的综合治疗.肿瘤分期、病理类型及治疗方式均与其预后相关.近年来涌现了大量有关MFH治疗及预后的分子生物学方面的研究,为MFH的治疗及预后评价提供了新的前景.     

体部伽马刀治疗恶性纤维组织细胞瘤术后肺转移患者的疗效分析

目的 探讨体部伽马刀治疗恶性纤维组织细胞瘤(MFH)术后肺转移患者的疗效和不良反应.方法 将9例MFH肺转移患者共40个病灶行体部伽马刀治疗,37个病灶以50％剂量线为处方剂量照射,单次剂量3～8 Gy,治疗8～15次;3个病灶以60％剂量线为处方剂量,单次剂量8～10 Gy,治疗5～7次.观察患者的近期疗效、总生存期...     

新辅助化疗联合放疗治疗中晚期鼻咽癌的疗效观察

目的研究新辅助化疗在治疗中晚期鼻咽癌(NPC)中的疗效。方法63例中晚期NPC病人随机分为单纯放疗组30例、新辅助化疗联合放疗组33例。化疗方案PFL方案(DDP80mg/m2~100mg/m2,d1;5-FU3.5/m248h;CF0.3,d1),共2~3疗程;化疗后2周常规放射治疗鼻咽癌原发灶DT68.0Gy/7周,颈转移灶DT65.0Gy/6周,颈预防剂量55.0Gy。结果新辅助化疗联合放疗组原发灶及颈转移灶完全缓解率优于单纯放疗组,毒性反应与单纯放疗组相比无明显差异。结论新辅助化疗联合放疗可提高中晚期NPC患者近期肿瘤缓解率,毒性反应可耐受,但远期生存率需进一步观察。     

新辅助化疗加放疗治疗鼻咽癌疗效观察

目的：比较新辅助化疗加放疗与单纯放疗治疗鼻咽癌的疗效。方法：214例患者随机分成2个组：1)观察组：新辅助化疗加常规放疗组；2)对照组：单纯常规放疗组。结果：放疗结束时观察组及对照组颈部淋巴结全消率94．6％及69．1％。前者优于后者；放疗结束后3个月观察组及对照组颈部淋巴结全消率95．8％及71．3％．前者仍优于后者并且能提高3a生存率。结论：新辅助化疗能提高对颈部淋巴结的局控制作用。改善近期疗效，而不增加放疗急性反应。     

新辅助化疗治疗卵巢癌的疗效及对免疫功能的影响

目的 探讨新辅助化疗治疗卵巢癌的疗效及对免疫功能的影响。方法 采用随机数字表法将76例卵巢癌患者分为对照组与观察组,每组38例。对照组患者予以肿瘤细胞减灭术⁺术后腹腔热灌注⁺术后化疗方案,观察组在对照组的基础上给予术前新辅助化疗。比较两组患者的治疗一般情况、疗效及不良反应;比较不同时间两组患者的免疫指标;对患者随访1年,观察其复发及生存情况。结果 观察组患者手术时间、住院时间均短于对照组,腹腔积液量、术中出血量均少于对照组,术后感染发生率低于对照组,差异均有统计学意义(P﹤0.05)。腹腔热灌注后、化疗后,观察组患者CD3⁺CD4⁺、CD3⁺CD56⁺、CD3⁺CD4⁺/CD3⁺CD8⁺均高于本组化疗前、手术后及对照组,差异均有统计学意义(P﹤0.05)。观察组患者临床疗效优于对照组,差异有统计学意义(P﹤0.05)。两组患者复发情况及生存情况比较,差异均无统计学意义(...     

肺恶性纤维组织细胞瘤

 本文报告了临床少见的肺原发恶性纤维组织细胞瘤4例。临床表现都有痰中带血。手术检查肿瘤外侵不明显，全部根治性切除，术后3例在1年内发生转移死亡。说明本瘤恶性程度很高，多术前即已发生血行转移。术后应及早给予化疗。     

可手术乳腺癌新辅助化疗近期疗效观察

目的 研究可手术乳腺癌患者手术前给予新辅助化疗(NCT)的安全性、近期疗效以及对手术方式的影响。方法 我院于1997年3月～2001年12月收治的224例可手术乳腺癌患者(Ⅱ～Ⅲ期)术前随机给予CMF(CTX+MIX+5-Fu)方案或CAF(CTX+ADM+5-Fu)方案化疗两个周期,全部患者治疗前均经针吸细胞学检查确诊,评价其近期疗效和毒性反应,将临床原发肿瘤对化疗的反应按WHO标准分为完全缓解(CR)、部分缓解(PR)、无效(NR)或进展(PD)。结果 全部224例化疗患者中,CR 17例,PR 136例,总有效率68.3％,无恶化病例;毒性反应主要表现为胃肠道反应和骨髓抑制。胃肠道反应主要表现为恶心、呕吐,其中Ⅱ～Ⅲ级为65.6％;骨髓抑制以白细胞减少为主,Ⅲ～Ⅳ级白细胞减少发生率为60.3%,经对症治疗后均可缓解。全部患者无因为化疗的毒性反应而终止治疗的病例。结论 对于可手术乳腺癌的患者手术前给予新辅助化疗(NCT)可以使原发灶明显缩小,能够为预测化疗效果提供实体依据,降低手术复杂性,缩小手术范围,提高患者术后的生活质量,并且安全可行,是一种提高治疗效果的重要治疗方法。     

Malignant fibrous histiocytoma of the rectum.

Malignant fibrous histiocytoma (MFH) of the gastrointestinal tract is a rare occurrence. We report a case of MFH of the rectum in a 55-year-old man. Ultrasound examination revealed thickening of the rectal wall and the biopsy study indicated MFH. The patient underwent abdominoperineal resection and chemoradiation and is doing well after 46 months. A high index of suspicion for colorectal MFH should be taken into account in order to avoid histological misdiagnosis.     

Malignant fibrous histiocytoma of the lung.

Two malignant fibrous histiocytomas arising primarily in the lung are described. The first was a large tumor of the right lower lobe in a 53-year-old man. The other tumor was found incidentally on routine roentgenograms in a 25-year-old woman and involved the left main pulmonary artery. The lesions could be resected but both patients developed early cerebral metastases. The neoplasms were predominantly fibroblastic, had a characteristic storiform pattern, and included large histiocytes with bizarre nuclei and a vacuolated cytoplasm. The ultrastructure of the cells in the fibroblastic areas was characterized by irregular nuclei and a cytoplasm with a well-developed endoplasmic reticulum and dilated cisternae. Some cells lacked the prominent endoplasmic reticulum of fibroblasts and others were characteristic histiocytes with numerous cytoplasmic lysosomes. The cases appear to be the first reported primary malignant fibrous histiocytomas of the lung.     

The efficacy of fluoropyrimidine-based adjuvant chemotherapy on biliary tract cancer after R0 resection

Background: The optimal treatment strategy for biliary tract cancer (BTC) after curative-intent resection remains con-troversial. The purpose of this study was to evaluate the efficacy of fluoropyrimidine-based adjuvant chemotherapy for BTC patients undergoing microscopically margin-negative (R0) resection. Methods: We retrospectively analyzed the clinical data of BTC patients who underwent curative-intent R0 resection. Patients were eligible if they received either fluoropyrimidine-based adjuvant chemotherapy or observation after R0 resection. Results: A total of 153 patients were included. In the entire patient cohort, no significant differences were observed in 5-year overall survival (OS) rates (48.4% vs. 39.6%,P= 0.439) or 3-year recurrence-free survival (RFS) rates (49.1% vs. 39.5%,P= 0.299) between patients who received fluoropyrimidine-based adjuvant chemotherapy or observation. However, for patients with stages Ⅱ and Ⅲ BTC, chemotherapy significantly improved 5-year OS rate (52.4% vs. 35.6%, P= 0.002) and 3-year RFS rate (55.5% vs. 39.1%,P= 0.021) compared with observation. Conclusion: Fluoropyrimidine-based adjuvant chemotherapy may prolong the survival of patients with stages Ⅱ and Ⅲ BTC after R0 resection.     

香菇多糖对肺癌化疗的辅助作用：40例配对分析

香菇多糖（ｌｅｎｔｉｎａｎ）是一种生物反应调节剂，本文用病例配对法对化疗同时应用香菇多糖及单化疗进行对照，各４０例，在一般条件相仿情况下，经治疗后观察到香菇多糖体对机体的一般状况（ＫＰＳ法），ＮＫ细胞活性，Ｔ细胞亚群中ＣＤ３，血红蛋白及血小板升高有一定作用，说明香菇多糖对患者化疗后的免疫功能有调节保护作用，且未发现不良副反应。     

The effect of prior adjuvant chemotherapy on survival in metastatic breast cancer

Some adjuvantly treated patients develop recurrent breast cancer and little is known about the effect of prior adjuvant chemotherapy on subsequent response rates to systemic therapy or on overall survival. We describe our retrospective comparison of 179 patients who received doxorubicin containing adjuvant chemotherapy and developed recurrent breast cancer on University of Arizona Cancer Center clinical trials with 202 non-adjuvantly treated patients entered onto clinical protocols for recurrent or metastatic breast cancer during the same period. Adjuvant failures had a shorter median survival from the date of onset of recurrent disease (18 months versus 28 months, P less than 0.001), a lower response rate to initial combination chemotherapy (38% versus 69%, P = 0.001), and a high incidence of CNS involvement at the time of relapse (11%). In patients having recurrent or metastatic breast cancer, a history of prior adjuvant chemotherapy appears to identify a subgroup who will have a higher incidence of CNS involvement, a lower response rate to chemotherapy and a shorter survival with metastatic disease. These findings may help explain the failure of improved relapse free survival seen in many adjuvant chemotherapy trials to result in improved overall survival.     

进展期胃癌不同切除术式对辅助化疗耐受性的影响

目的比较不同胃癌根治术式对术后辅助化疗耐受性及完成率的影响。方法回顾性观察不同术式对进展期胃癌病例术后辅助化疗的影响,比较严重不良反应发生率、化疗终止原因、内镜下反流性食管炎发病率及吻合口病变情况。结果 327例可切除的局部进展期胃癌患者,其中全胃切除术式81例,近端胃切除85例,远端胃切除161例;术后化疗完成率分别为40.7%,21.2%及36.6%。近端胃切除组化疗严重不良反应发生率为48.2%,明显高于其他两组,差异有统计学意义(P<0.05)。导致近端胃切除组化疗不耐受的原因中,消化道不良反应所占比例为43.3%,尤其是呕吐反应的发生率为35.8%,明显高于其他两组,差异有统计学意义(P<0.05)。近端胃切除组反流性食管炎及吻合口溃疡的发生率亦明显高于其他两组,差异均具有统计学意义(均P<0.05)。结论近端胃切除组病例术后化疗不良反应发生率高,化疗完成率低,而全胃切除术后辅助化疗耐受相对好,化疗完成率高,可提高胃上部癌的治愈率并降低复发率。