参麦注射液对结直肠癌化疗患者免疫功能的影响

 目的 探讨参麦注射液对结直肠癌化疗患者免疫功能的影响。方法 选取2017-03至2018-02青海省人民医院收治的结直肠癌化疗患者88例,随机分为研究组和对照组,每组44例。全部患者采用XELOX化疗方案治疗,对照组采用脾多肽治疗,研究组在对照组基础上,采用参麦注射液治疗,根据RECIST实体瘤疗效标准评估两组的疗效。检测两组治疗前后的血清CD3⁺、CD4⁺、CD4⁺/CD8⁺、NK细胞。采用卡氏评分(KPS)评估两组的生存质量,记录两组的不良反应发生情况。结果 两组的缓解率对比,研究组为43.18%,对照组为36.36%,差异无统计学意义(P>0.05)。两组的有效率对比,研究组(84.09%)高于对照组(65.09%),差异有统计学意义(P<0.05)。研究组治疗后的CD3⁺、CD4⁺、CD4⁺/CD8⁺、NK细胞明显升高,且高于对照组治疗后的水平,差异有统计学意义(P<0.05)。研究组的生存质量改善程度(36.36%)优于对照组(27.27%),差异有统计学意义(P<0.05)。研究组的恶心呕吐、白细胞减少、肝损伤、神经毒性发生率均低于对照组,差异有统计学意义(P<0.05)。结论 参麦注射液能进一步提高结直肠癌化疗的疗效,改善免疫功能及生存质量。     

复方苦参注射液对肝癌动脉化疗栓塞联合射频消融治疗后的影响

目的:分析复方苦参注射液对肝癌动脉化疗栓塞(TACE)联合射频消融(RFA)治疗后的影响.方法:选择接受TACE联合RFA治疗的64例肝癌患者,随机分为研究组和对照组各32例.研究组在TACE联合RFA治疗基础上加用复方苦参注射液治疗,对照组仅接受TACE联合RFA治疗,比较2组治疗后总有效率、免疫功能指标(CD4+、...     

89Sr治疗乳腺癌和前列腺癌多发性骨转移的临床观察

目的 探讨放射性核素89Sr治疗乳腺癌和前列腺癌多发性骨转移患者的临床效果.方法 回顾性分析30例乳腺癌和40例前列腺癌多发性骨转移患者接受89Sr治疗的病例资料,采用Karnofsky评分量表和骨显像方法进行疗效评估.结果 乳腺癌组的止痛总有效率为79%,前列腺癌组的止痛总有效率为85%,两组患者之间差异无统计学意义(x2=0.78,P＞0.05).两组患者的生存质量均有明显改善,治疗前后两组患者的Karnofsky评分均有明显提高(t=2.46,P＜0.05;t=2.68,P＜0.05).治疗后两组患者均未见明显骨髓抑制与肝肾功能损伤.结论 89Sr治疗乳腺癌和前列腺癌多发性骨转移止痛效果良好,患者生存质量有明显提高.     

复方苦参注射液合并化疗治疗晚期肿瘤近期疗效观察

目的探讨复方苦参注射液对晚期肿瘤的近期疗效。方法对80例中晚期肿瘤患者进行随机分组治疗,40例给予单纯化疗,40例给予复方苦参注射液联合化疗。观察两组治疗前后生活质量、白细胞计数、T细胞亚群。结果治疗组在改善患者生活质量（有效率为70.0%）,抑制瘤体生长（有效率为75.0%）等方面的疗效均优于对照组,经统计学处理两组各方面的疗效差异均有显著性意义（P〈0.05〉。结论复方苦参注射液治疗中晚期癌症有较好的近期疗效。     

放射性碘125粒子植入联合锶核素89及云克治疗碘131难治性甲状腺癌骨转移疗效分析

目的探讨应用放射性碘125(¹²⁵I)粒子植入联合锶核素89(⁸⁹Srcl₂)及云克治疗碘131(¹³¹I)难治性甲状腺癌(RAIR-DTC)骨转移的临床疗效。方法选取北部战区总医院自2016年1月至2018年10月收治的57例¹³¹I RAIR-DTC骨转移患者为研究对象。所有患者均初始给予⁸⁹Srcl₂内照射+云克联合治疗。3个月后,行CT引导下¹²⁵I粒子植入术。分别于治疗前后,记录并比较⁸⁹Srcl₂内照射+云克治疗、⁸⁹Srcl₂内照射+云克联合粒子治疗患者功能状态评分(KPS)、疼痛视觉模拟评分(VAS)。于术后1个月,比较不同疼痛评分患者的疼痛缓解率。按照世界卫生组织实体瘤近期疗效判别标准评价患者骨转移病灶疗效。记录并比较患者治疗前后血清Tg水平与不良反应发生情况。结果根据治疗前3 d患者的疼痛评分,将其分为Ⅰ级...     

骨转移瘤患者 89SrCl2治疗后免疫功能的变化

目的　研究骨转移瘤患者89SrCl2 治疗后免疫功能变化。方法　选择已确诊骨转移瘤经89SrCl2 治疗的患者 4 2例 ,与正常对照组 2 0例比较患者治疗前后T淋巴细胞亚群CD 4、CD 8、CD 4 CD 8值 ,分析治疗有效组和无效组免疫指标及病灶数变化。结果　骨转移瘤患者治疗前各组间免疫学指标差异无显著性 (P >0 0 5 ) ,对照组与骨转移瘤患者及骨转移瘤患者治疗前后各免疫学指标差异均有显著性 (P <0 0 5 )。治疗后有效组和无效组间各指标差异亦有显著性 (P <0 0 5 )。经89SrCl2治疗 ,4 2例患者中 37例 (88 10 % )免疫功能得到改善 ,以疼痛评分为指标则 4 2例患者中 33例(78 5 7% )有效 ,2 9例 (6 9 0 5 % )病灶数减少。结论　89SrCl2 治疗骨转移瘤有效 ,并可提高免疫功能 ;治疗后免疫指标变化可反映治疗效果。     

~(89)Sr治疗乳腺癌转移性骨痛的疗效评价

目的　评价89SrCl2 对乳腺癌转移性骨痛的临床疗效。方法　对 86例乳腺癌骨转移患者按体重静脉注射89Sr 1.48～ 2 .2 2MBq/kg。结果　治疗后骨痛减轻或消失 72例 ,总有效率为83 72 % ;治疗后骨显像有 5 9.30 % (5 1例 )骨转移灶代谢减低 ,治疗前后ROI比值比较 ,P <0 .0 5。治疗后有 2 7.90 % (2 4例 )出现Ⅰ～Ⅱ度血液学毒性反应 ,对心、肝、肾功能几乎没有影响。结论　89Sr对缓解乳腺癌骨转移瘤疼痛有较好疗效 ,并有一定的治疗作用 ,副作用小 ,可重复用药。     

复方苦参注射液在食管癌放疗中的临床效果观察

目的观察分析复方苦参注射液在食管癌放疗中应用的疗效及降低急性放疗副反应的情况。方法对我科住院的67例食管癌患者资料进行回顾性分析,病人分为观察组和对照组两组,对照组行单纯放疗,总剂量DT60-66Gy／30-33次／6-7w,2．0Gy／次／d。观察组在放疗的同时,加用复方苦参注射液静脉滴注治疗。结果放疗结束时以食管吞钡X线造影片判断疗效,观察组和对照组的有效率分别为94．3％,81．3％（X^2=1．60,P〉0．05）,差异无统计学意义;观察组生存质量改善率优于对照组（P〈0．01）;观察组放射性食管炎及放射性气管炎发生率低于对照组（P〈0．05）。结论食管癌放疗的同时加用复方苦参注射液治疗,虽不能明显提高疗效,但可以减少急性放疗副反应。改善患者的一般状况。     

89SrCl2与153Sm-乙二胺四亚甲基膦酸治疗骨转移癌的对比研究

目的 对比研究89SrCl2和153Sm-乙二胺四亚甲基膦酸(153Sm-EDTMP)治疗骨转移癌疗效.方法 120例骨转移患者随机分为89SrCl2治疗组和153Sm-EDTMP治疗组,分别为69例和51例,89SrCl2剂量为1.11～2.22 MBq/Kg,153Sm-EDTMP剂量为25.9～37.0 MBq/kg,3～6月复查SPECT,对止痛效果、转移灶变化及不良反应进行比较分析.结果 89SrCl2组总有效率、显效、有效、无效分别为92.8%、69.6%、23.3%、7.2%;153Sm-EDTMP组的总有效率、显效、有效、无效分别为94.2%、66.7%、27.5%、5.8%,两组比较的差异无统计学意义(X2=4.98,P>0.05);89SrCl2治疗组骨转移病灶Ⅰ级(变淡,缩小或消失,无新增病灶出现)为56.5%,153Sm-EDTMP组为54.9%,两组比较的差异无统计学意义(X2=4.81,P>0.05);骨髓抑制情况(白细胞和血小板中任一项降低)分别为40.8%和59.2%,两组比较的差异有统计学意义(X2=7.45,P<0.05).结论 153Sm-EDTMP和89SrCl2控制乳腺癌、前列腺癌及大多数肺癌骨转移疼痛有效,可根据经济条件选择相应药物.89SrCl2疗效持久,相对骨髓抑制较小,更安全可靠,可作为早期骨转移患者的首选药物.     

两种化疗方案对转移性乳腺癌外周血T细胞亚群 和临床预后影响的比较

 目的 探讨贝伐单抗联合曲妥珠单抗+紫杉醇(TH)方案化疗对人类表皮生长因子受体2(human epidermal growth factor receptor-2, Her-2)阳性的转移性乳腺癌患者外周血T细胞亚群和临床预后的影响。方法 选取Her-2阳性的乳腺癌患者100例,随机分为研究组和对照组;研究组采用贝伐单抗联合TH方案化疗,对照组仅采用TH方案化疗。随访终点为2年,主要观察指标为CD4⁺T细胞、CD8⁺T细胞、实体瘤疗效评价等级、无进展生存期和2年病死率。结果 两组治疗前后CD8⁺T细胞差异均无统计学意义。两组治疗前CD4⁺T细胞差异无统计学意义(P=0.422)。治疗后,研究组CD4⁺T细胞显著高于对照组(P=0.011)。研究组完全缓解、部分缓解、病情稳定和病情进展发生率分别为0.0%、36.0%、42.0%和22.0%,对照组为0.0%、18.0%、44.0%和38.0%。2年后,研究组9例死亡,病死率为18.0%,对照组20例死亡,病死率为40.0%,差异有统计学意义(P=0.015)。Wilcoxon检验显示研究组无进展生存期显著高于对照组(P=0.007)。结论 贝伐单抗联合TH方案化疗有助于改善Her-2阳性的转移性乳腺癌患者免疫功能和临床预后。     

唑来膦酸联合89Sr治疗前列腺癌骨转移的临床疗效

目的评估唑来膦酸联合89Sr治疗前列腺癌骨转移的临床疗效。方法74例前列腺癌骨转移患者按简单随机分组方法分为3组:唑来膦酸联合89Sr治疗组（A组）25例,年龄46~87岁,中位年龄66岁;单独给予唑来膦酸治疗组（B组）25例,年龄43~89岁,中位年龄65岁;单独给予89Sr治疗组（C组）24例,年龄47~85岁,中位年龄66岁。其中,B组和C组为对照组。随访6个月,观察患者骨骼疼痛缓解情况和骨转移病灶数目改善情况。结果3组患者的基线特征相似。治疗后,A组总的疼痛缓解率为88.0%,B组和C组分别为72.0%和79.2%,A组疼痛缓解情况与B组和C组相比差异有统计学意义（χ2=8.959,P < 0.05）。A组骨转移病灶好转率为88.0%,B组和C组分别为44.0%和75.0%,A组病灶好转情况分别与B组、C组相比,差异有统计学意义（χ2=9.096,P < 0.05）。结论唑来膦酸联合89Sr治疗前列腺癌骨转移较单独给药具有更好的缓解疼痛作用,89Sr治疗可有效减少骨转移病灶,提高患者的生活质量。     

Transcatheter arterial embolization for bone metastases from hepatocellular carcinoma

The objective of this study was to determine which of the following three methods is the most effective for the treatment of bone metastases from hepatocellular carcinoma (HCC): transcatheter arterial embolization (TAE); combination of TAE and external radiotherapy; or external radiotherapy alone. Thirty-nine metastatic bone lesions from HCC in 33 patients were retrospectively reviewed. Each lesion underwent either TAE alone (group A, n = 11), TAE followed by radiotherapy (group B, n = 17), or radiotherapy alone (group C, n = 11). They were evaluated on the following subjects: pain relief; improvement of daily activities; and complications. Each treatment was effective for pain relief (89-94%) and improvement of daily activities (73-82%). The mean time interval from the beginning of each treatment to the onset of initial pain relief was 4.7 days in group A, 4.8 days in group B, and 15 days in group C. Recurrence of the pain after the initial pain relief was noted in 75% in group A, 20% in group B, and 88% in group C. Pyrexia and local pain commonly occurred after TAE. In conclusion, TAE is effective in relieving pain immediately and in improving the patients' daily activities. The combination of TAE and radiotherapy is recommended for permanent pain relief.     

89SrCl联合依班膦酸钠治疗多发性骨转移癌疼痛

目的 观察89SrCl2联合依班膦酸钠治疗多发性骨转移癌疼痛与单独应用依班膦酸钠或89SrCl2治疗的临床疗效。方法84例骨转移癌疼痛患者,分为3个治疗组,其中30例采用89SrCl,联合依班膦酸钠方法,26例采用单纯89SrCl2治疗,28例采用依班膦酸钠治疗。用SPSS13．0统计软件,疗效比较采用行×列表资料的r检验。结果联合治疗组骨痛缓解总有效率为96．6％（29／30）,依班膦酸钠组及89SrCl2治疗组总有效率分别为71．4％（20／28）和73．1％（19／26）。联合用药组与单独用药组治疗后骨痛缓解有效率（X2=7．497）,全身状况Kamofsky评分提高率[80．0％（24／30）与50．0％（14／28）,53．8％（14／26）,X2=35．476]和病灶治疗有效率[47．6％（50／105）与11．2％（11／98）,22．2％（20／90）,X2=6．564]间比较差异有统计学意义（P均〈0．05）。结论89SrCl2联合依班膦酸钠是治疗骨转移性癌疼痛较为有效和可行的方法。联合用药临床疗效优于单独用药。     

局部放疗联合89Sr治疗骨转移癌的疗效观察

目的评价局部放疗配合放射性核素^89Sr治疗骨转移癌的疗放，分析单纯放疗单纯核素^89Sr治疗及联合治疗的副作用。方法观察60例确诊为骨转移癌的患者，分为3组，每组20例。局部放疗（A组），采用6MV直线加速器外照射给予吸收剂量30—60Gy，2—4周，局部放疗＋^89Sr治疗（B组），单纯^89Sr治疗（C组）放射性核素^89Sr静脉内注射3—4mCi。结果治疗后B组骨痛缓解，原发灶改善明显好于A、C组；新增疼痛部位及转移灶均少于A、C组（P〈0．05）。治疗后血液学的毒性3组差异统计学意义（P〉0．05）。结论局部放疗配合^89Sr治疗骨转移癌有较好的疗效，提示对单发性骨转移患者的压痛明显部位给予局部外照射止痛效果明显，对多发骨转移且病灶相距较近的给予放疗联合^89Sr治疗效果安全可靠，对全身性多发性骨转移者采用单纯放射性核素^89Sr治疗对于止痛和控制骨转移有一定疗效。     

Der Einfluss palliativer Strahlentherapie auf Schmerz und Lebensqualität bei Patienten mit Knochenmetastasen

BACKGROUND AND PURPOSE: Palliative irradiation is used to provide pain relief and to increase quality of life. Most studies exclude patients with advanced cancer disease and, therefore, a positive selection results. This prospective clinical study investigates the effect of palliative radiotherapy on pain and quality of life of patients with painful bone metastases. PATIENTS AND METHODS: 263 patients with bone metastases due to advanced cancer were observed with respect to pain and quality of life during a 2-month course of radiotherapy. Missing data were substituted by the LOCF method (last observation carried forward) to prevent a biased reduction of data. RESULTS: Radiotherapy resulted in pain relief. In the complete group, pain medication was not increased. Quality of life was not affected positively. Side effects of radiotherapy increased remarkably. CONCLUSION: Radiotherapy leads to pain relief. However, risks and benefits must be considered critically due to side effects.     

Treatment of bone metastases of prostate cancer with strontium-89 chloride: efficacy in relation to the degree of bone involvement

This retrospective study evaluated the toxicity and efficacy of strontium-89 chloride (Metastron, Amersham) in 94 patients with painful bone metastases of prostate cancer (117 injections of 150 MBq) and compared the efficacy of treatment in patients with moderate and extensive bone involvement. The predictive value of flare response with regard to analgesic response was also studied. High-grade leukothrombopenias were observed after only 5% of injections. An improvement in quality of life was obtained in 65% of cases, a decrease in pain in 78% (31% complete response) and a reduction of analgesics in 60%. Efficacy was significantly better for pain decrease (P=0.005) and reduction of analgesics (P=0.018), and response was significantly longer (P<0.0035) in patients with moderate than in patients with extensive bone involvement. The flare response observed in 23% of cases was not predictive of pain response (P=0.919) or reduction of analgesics (P=0.353). A second dose prolonged analgesia in three-quarters of cases without any apparent increase in toxicity. These results confirm the benefit of 89Sr chloride for the treatment of metastatic bone pain and suggest that internal radiotherapy should be started earlier. A bone scan could be proposed at the time of hormonal escape resulting in bone pain, and internal radiotherapy could be initiated when several metastatic foci exist, even if only one is painful. In this way, pain-free follow-up could be prolonged, and the transition to other therapeutic approaches, particularly opioids, delayed.     

Bone pain palliation with strontium-89 in breast cancer patients with bone metastases and refractory bone pain

Fifteen patients with breast cancer and skeletal metastases who had bone pain refractory to opioid analgesics and who were not eligible for or had not responded to local field radiotherapy, were treated with strontium-89. All patients had received previous treatment with chemotherapy and radiotherapy for bone metastases. Severity of bone pain, sleeping pattern, mobility and dependency on analgesics were evaluated before and 4, 8 and 12 weeks after⁸⁹Sr administration. Patients received 2 MBq/kg (118–148 MBq) of⁸⁹Sr by i.v. injection. Pain relief and a reduction in analgesic requirements were observed in 7 of the 15 (47%) patients, with a reduction in the severity score from 34% to 71%. Duration of the response varied from 3 to 7 months. A decrease in peripheral blood cell count was observed in 11 patients: a 15%–66% reduction in white cell count and a 14%–75% reduction in platelet count were detected at 12 weeks after treatment in these patients. We conclude that⁸⁹Sr is effective (47% response rate) for bone pain palliation in patients with bone metastases from breast cancer. Dependency on opioid analgesics may be reduced in patients with refractory bone pain.     

Effects of low-dose cisplatin on 89Sr therapy for painful bone metastases from prostate cancer: a randomized clinical trial.

This study evaluated the effects of low-dose cisplatin plus 89Sr versus 89Sr alone in the treatment of painful bone metastases from prostate cancer, addressing both pain palliation and cytostatic effects. METHODS: Seventy patients with metastatic hormone-refractory prostate cancer were randomized into 2 groups: One group (arm A) received 148 MBq 89Sr plus 50 mg/m(2) cisplatin, and the other group (arm B) received 148 MBq 89Sr plus placebo. After treatment, the patients were followed up until death to evaluate the outcome variables: grade and duration of pain palliation, onset of new painful sites, changes in bone disease, global survival, serum prostate-specific antigen and alkaline phosphatase changes, and hematologic toxicity. RESULTS: Overall pain relief occurred in 91% of patients in arm A and 63% of patients in arm B (P < 0.01), with a median duration of 120 d in arm A and 60 d in arm B (P = 0.002). New painful sites on previously asymptomatic bone metastases appeared in 14% of patients in arm A and in 30% of patients in arm B (P = 0.18). The median survival without new painful sites was 4 mo in arm A and 2 mo in arm B (P = 0.04). Bone disease progression was observed in 27% of patients in arm A and in 64% of patients in arm B (P = 0.01). Median global survival after therapy was 9 mo in arm A and 6 mo in arm B (P = 0.30). Transient and moderate hematologic toxicity, as determined by World Health Organization criteria, was apparent in both arms without significant differences. CONCLUSION: The addition of a low dose of cisplatin enhances the effect of a standard dose of 89Sr without significant side effects, producing a significant improvement in pain palliation and a cytostatic effect on bone disease.