经PCS区域动脉灌注健择和5-氟尿嘧啶治疗中晚期胰腺癌的疗效观察

 目的　评价经PCS区域动脉灌注健择和 5 氟尿嘧啶治疗中晚期胰腺癌的疗效和安全性。方法　 36例中晚期胰腺癌患者分为 2组 ,16例行经PCS区域动脉灌注化疗 (B组 ) ,另 2 0例行外周静脉全身化疗 (A组 )。结果　B组临床受益反应有效率为 75 .0 % (12 / 16 ) ,A组为 4 5 .0 % (9/ 2 0 ) (P <0 .0 5 ) ,A组和B组 6个月、1年生存率和中位生存期分别为 35 .0 %、15 .0 %、6 .8个月和 6 8.7%、37.5 %、11.4个月 ,P<0 .0 5。结论　经PCS区域动脉灌注化疗较外周静脉化疗能提高中晚期胰腺癌的临床受益反应、改善生活质量 ,提高远期生存率。     

动脉灌注结合全身静脉化疗治疗中晚期胰腺癌的临床观察

目的:观察动脉灌注结合全身静脉化疗治疗中晚期胰腺癌的疗效。方法:对12例中晚期胰腺癌患者选择性给予腹腔干动脉和/或肠系膜上动脉灌注吉西他滨和5-氟尿嘧啶,第8天再给予吉西他滨全身静脉化疗。3周为1个治疗周期,完成两个周期后复查CT评价疗效,观察临床受益反应、有效率、生存期及毒副反应。结果:全组患者临床受益率66.7%,有效率(CR PR)16.7%,中位生存时间6.7个月,6个月及9个月累积生存率分别为59.4%、29.6%。毒副反应多为Ⅰ°～Ⅱ°均能耐受。结论:动脉灌注结合全身静脉化疗治疗中晚期胰腺癌可获得较好的疗效,提高生存质量,毒副反应较小,值得临床推广应用。     

支气管动脉灌注化疗治疗肺癌的临床研究

目的　探讨支气管动脉灌注化疗 (BAI)对中晚期肺癌的疗效及影响因素。方法　对 45例中晚期肺癌进行BAI治疗 ,与同期接受全身化疗的 40例中晚期肺癌进行比较。结果　除开 1例大细胞肺癌 ,BAI组完全缓解 (CR) 15例 ( 3 4.1% ) ,部分缓解 (PR) 18例 ( 4 0 .9% ) ,缓解 (CR +PR) 3 3例 ,缓解率 75 .0 % ,与全身化疗之间的疗效 ( 5 0 .0 % )有显著性差异 ,前者优于后者 (P <0 .0 5 ) ,前者毒副反应亦少于后者 (P <0 .0 5 ) ,但BAI组有 1例灌注后截瘫。在BAI组中 ,小细胞未分化癌、鳞癌、腺癌的缓解率分别为 94.5 %、66.6%、40 .0 %。BAI组鳞癌和腺癌的缓解率显著高于全身化疗组 (P <0 .0 5 )。结论　BAI的疗效优于全身静脉化疗 ,且毒副反应低。鳞癌首选BAI治疗 ,小细胞未分化癌以全身化疗为基础 ,辅助应用BAI治疗 ,腺癌可先行BAI治疗 ,配合全身化疗或放疗     

晚期胃癌术后腹腔温热灌注化疗的临床观察

目的 :评价Ⅲ、Ⅳ期胃癌术后腹腔温热灌注化疗和全身静脉化疗的疗效和毒副反应。方法 :病例随机分为腹腔温热灌注化疗组 4 2例和静脉化疗组 36例 ,计算 2年和 3年的各期生存率及总生存率 ,观察毒副反应 ,分析两种治疗方法的差异。结果 :两组的 3年生存率Ⅲ期分别为 5 2 6 %和 13 3% ,Ⅳ期分别为 34 8%和 4 8% ;Ⅲ和Ⅳ期的 3年总生存率分别为 4 2 9%和 8 3% :两组之间在各期的 3年生存率 ,P <0 0 5和 3年总生存率上差异有显著意义 ,P <0 0 1。消化道反应和骨髓抑制 ,腹腔化疗组显著低于静脉化疗组 ,P <0 0 5 ;腹痛、腹胀症状则腹腔化疗组较严重 ,P <0 0 1。结论 :Ⅲ、Ⅳ期胃癌术后腹腔温热灌注化疗可以提高 3年生存率和减少治疗的毒副反应     

介入及化疗综合治疗高危大肠癌

目的　观察介入方法综合治疗高危大肠癌的远期疗效。方法　大肠癌根治术及再次根治术 ;术中门脉置管及手术前后选择性肝动脉 ,肠系膜上或肠系膜下动脉 ,髂内动脉或腹壁下动脉插管化疗 ;术后腹腔灌注化疗 ;全身辅助化疗 ;局部辅助放疗 ;中医中药和免疫治疗等有机综合治疗方法随机性治疗 2 2例高危大肠癌 ,并与常规综合治疗 2 5例对照 ,观察其 1.5年及 2 .5年无瘤生存率。结果　治疗组 1.5年无瘤生存率 90 .9% ,对照组 72 .0 % ,两者比较无显著性差异 (P >0 .0 5 ) ,治疗组 2 .5年无瘤生存率 76 .9% ,对照组为 42 .9% ,两者比较差异显著 (P <0 .0 5 )。治疗组的毒副反应及并发症均较对照组减轻。结论　有机溶入介入疗法及中医中药的综合治疗方法 ,可提高高危大肠癌病人 1.5年及2 .5年无瘤生存率 ,且治疗的毒副反应及并发症均较轻。     

肝动脉介入治疗加（减）全身化疗治疗转移性肝癌的临床观察

目的　分析肝动脉介入治疗加 (减 )全身化疗治疗转移性肝癌。方法　对 16 4例转移性肝癌进行回顾性研究 , 组 10 0例 ,采用肝动脉介入治疗加 (减 )全身化疗 ; 组 6 4例 ,采用单纯静脉化疗 ,观察两组疗效、生存情况 ,并进行统计分析对比。结果　 组 CR2 6 .0 % ,PR5 8.0 % ,有效率 84.0 % ; 组 CR6 .3% ,PR18.8% ,有效率2 5 .0 % , 组疗效显著高于 组 (P<0 .0 1)。生存率 1～ 5年 组分别为 85 .6 %、42 .6 %、2 6 .4%、3.6 %、2 .4% ; 组分别为 2 6 .0 %、15 .0 %、8.0 % ,4～ 5年生存率均为 0。 组生存率显著高于 组 (P<0 .0 1)。结论　肝动脉介入治疗加 (减 )全身化疗是非手术治疗转移性肝癌较为有效的方法。     

放疗加全身辅助化疗治疗中晚期鼻咽癌

目的　观察放疗加全身辅助化疗治疗中晚期鼻咽癌的客观疗效及毒副反应。方法　采用放疗加全身辅助化疗治疗中晚期鼻咽癌病人 30例 (放化组 ) ,以同期行单纯放疗的鼻咽癌病人 30例作对照组 (单放组 )。单放组采用6 0 Co常规外照射 ,鼻咽部剂量 66～72Gy/7～ 8周 ,颈部根治量 65～ 75Gy/6.5～ 7.5周。放化组加用顺铂 (DDP)、亚叶酸钙 (CF)及氟尿嘧啶 (5 -Fu)化疗二个疗程 ,休息一周后放疗。结果 :1、2、3年生存率放化组分别为 91.8%、84.5 %、71.4% ;单放组为 84.9%、76.2 %、5 8.7% (P <0 .0 5 )。 1、2、3年局控率放化组分别为 85 .9%、81.2 %、73.1% ;单放组为 79.5 %、5 6.6%、48.4% (P <0 .0 5 )。放化组出现远处转移平均 18.2个月 ,单放组 8.8个月 (P <0 .0 5 )。结论　放疗加全身辅助化疗治疗中晚期鼻咽癌能提高远期生存率、局控率及延长出现远处转移的时间     

经动脉持续灌注化疗治疗中晚期胰腺癌的临床分析

 目的 比较经动脉持续灌注化疗和全身静脉化疗治疗中晚期胰腺癌的临床疗效，探讨选择性动脉持续灌注化疗的临床应用价值。方法 51例中晚期胰腺癌，其中25例采用经动脉持续灌注吉西他滨和5-Fu方案，26例采用经外周静脉灌注吉西他滨和5-Fu方案。应用世界卫生组织实体瘤疗效评定标准评价疗效，肿瘤体积测量采用MRI或CT。使用临床受益反应（CBR）对疼痛、体力状况及体重改变情况作出综合评价。采用WH0抗肿瘤药物急性与亚急性毒性分级标准对不良反应进行评价。结果 动脉灌注化疗组的有效率（32．0％）高于外周静脉化疗组（23．1％），但差异无显著性。动脉灌注化疗组的临床受益率（80．0%）高于外周静脉化疗组（50．0％），差异有显著性。6个月、9个月、1年的累积生存率和中位生存时间，动脉灌注化疗组高于外周静脉化疗组，差异有显著性。按WHO分级标准，两组患者不良反应之间无显著性的差异。结论 经动脉持续灌注吉西他滨和5-Fu较外周静脉灌注吉西他滨和5-Fu能提高中晚期胰腺癌的临床受益率和生存期，其方法安全可靠，且不良反应少。     

进展期胃癌术后双径路化疗的临床研究

目的　比较双路化疗与全身化疗治疗进展期胃癌的疗效和毒副反应。方法　 6 5例进展期胃癌随机分为 2组 ,其中 30例双路化疗 ,35例全身化疗。结果　双路化疗组 2年 ,3年 ,4年 ,5年生存率明显高于全身化疗组 (P <0 .0 5 ) ,双路化疗组的腹腔复发和(或 )肝脏转移明显少于全身化疗 (P <0 .0 5 ) ,2组的主要毒副反应无差异 (P <0 .0 5 ) ,未见并发症。结论　双路化疗可提高进展期胃癌生存率 ,对防治腹腔复发和 (或 )肝脏转移有明显疗效。     

放化疗同步治疗中晚期宫颈癌疗效观察

目的:探讨放疗同步动脉灌注化疗及静脉化疗治疗中晚期宫颈癌的疗效及毒副反应。方法:将60例Ⅱb期～Ⅲb期宫颈癌患者随机分为2组:同步放疗联合动脉灌注及静脉化疗组(综合组)30例,单纯放疗组(单放组)30例;两组放疗方法相同,综合组于放疗前给予PVB(顺铂、长春新碱、博来霉素)髂内动脉灌注化疗1次及放疗中、后予PVB方案静脉化疗2周期,每周期间隔28天,共化疗3周期。比较两组病例近期、远期疗效及毒副反应。结果:综合组与单放组近期有效率分别为93.3%、70%(P<0.05);1年、3年、5年生存率综合组分别为86.7%、80%、73.3%,单纯放疗组分别为76.7%、50%、46.7%,两组1年生存率比较无统计学意义(P>0.05),3年、5年生存率比较有统计学意义(P<0.05)。综合组骨髓抑制及消化道反应发生率均高于单纯放疗组(P<0.05),对症治疗后均可耐受。结论:放疗同步动脉灌注及静脉化疗治疗晚期宫颈癌可提高患者治疗效果。     

经皮左锁骨下药盒肝动脉灌注拓僖为主治疗晚期肝癌临床分析

目的观察经皮左锁骨下药盒肝动脉灌注拓僖为主治疗晚期原发性肝癌的近期疗效.方法晚期原发性肝癌82例随机分两组: A组(一次性插管组)40例,每月一次插管介入化疗栓塞治疗;B组(药盒系统组)42例,经左锁骨下动脉植入药盒系统,栓塞治疗后连续灌注拓僖5 d,6 mg/(m2*d).结果 A组PR 19例(47.5%),NC 18例(45.0%),PD 3例(7.5%);B组PR 30例(71.4%),NC 9例(21.4%),PD 3例(7.1%).两组相比B组疗效明显优于A组(P<0.05),毒副作用B组明显低于A组(P<0.05).结论经皮左锁骨下药盒肝动脉灌注拓僖为主治疗晚期原发性肝癌副作用小,疗效高,值得进一步研究.     

经动脉灌注化疗辅助静脉化疗对无法手术晚期胃癌患者的治疗效果#br#

目的研究经动脉灌注化疗辅助静脉化疗对无法手术的晚期胃癌患者的治疗效果。方法选取青岛市市立医院消化内科2014年6月—2017年7月收治的晚期胃癌患者104例,其中60例采用全身静脉化疗（静脉组）,44例采用经动脉灌注化疗联合全身静脉化疗（联合组）;比较两组化疗后的效果、化疗期间的不良反应及化疗前后患者血清癌胚抗原（CEA）、糖类抗原125（CA125）、糖类抗原19 9（CA19 9）、组织多肽特异性抗原（TPS）水平,比较两组的2年生存率及总生存时间。结果联合组患者的总有效率（7500%）高于静脉组（5333%）,差异有统计学意义（P<005）;化疗前,联合组与静脉组的血清CEA、CA125、CA19 9、TPS水平差异无统计学意义（P>005）;化疗后,两组患者的血清CEA、CA125、CA19 9、TPS水平均较本组化疗前降低,且联合组低于静脉组,差异有统计学意义（P<005）;两组患者的骨髓抑制、血红蛋白降低、血小板减少、恶心呕吐、腹泻、口腔黏膜炎、肝肾损伤的发生程度差异无统计学意义（P>005）;两组2年随访失访率、2年生存率差异无统计学意义（P>005）;联合组的总生存时间（19个月）长于对照组（12个月）,差异有统计学意义（P<005）。结论经动脉灌注化疗辅助静脉化疗对延长无法手术晚期胃癌患者的生存期有一定益处。     

腔内支架置入术联合经导管动脉灌注治疗中晚期食管癌对患者免疫功能影响情况的研究

目的 探讨腔内支架置入术联合经导管动脉灌注对中晚期食管癌的治疗效果及对患者免疫功能的影响.方法 回顾性分析100例接受治疗的中晚期食管癌患者的临床资料,根据治疗方式不同将患者分为单纯化疗组和联合治疗组,每组各50例.单纯化疗组患者给予单纯化疗药物治疗,联合治疗组患者在单纯化疗药物治疗的基础上给予腔内支架置入术,并经导管动脉灌注治疗.观察两组患者的治疗效果,比较两组患者治疗前后免疫功能、生活质量的差异.结果 联合治疗组患者治疗的有效率为74.00%,高于单纯化疗组的50.00%(P=0.013);治疗前,两组患者的IgG、IgA和IgM水平比较,差异均无统计学意义(P﹥0.05);治疗后,联合治疗组患者的IgG、IgA和IgM水平均高于单纯化疗组(P﹤0.05);治疗前,两组患者的生活质量评分比较,差异无统计学意义(P﹥0.05);治疗后,联合治疗组的生活质量评分高于单纯化疗组(P﹤0.05).结论 腔内支架置入术联合经导管动脉灌注对中晚期食管癌有较好的治疗效果,可明显改善患者的免疫功能,提高其生活质量.     

肝动脉灌注化疗与全身化疗治疗胃肠道肿瘤肝转移的对比分析

目的：比较肝动脉灌注化疗与全身化疗治疗胃肠道肿瘤肝转移癌的疗效和毒副作用。方法：60例病人被随机分成动脉灌注组（30例）和全身化疗组（30例），动脉灌注组：25例病人施行肝动脉化疗药灌注并行肿瘤供血动脉栓塞，5例病人单纯肝动脉药物灌注，化疗方案：亚叶酸钙＋氟尿嘧啶＋羟基喜树碱＋顺铂。全身化疗组：化疗药同动脉灌注组。结果：与全身化疗组比较，动脉灌注组近期有效率、半年和1年生存率明显提高，统计学分析有明显差异（P〈0．05），治疗进展时问、中位生存时间、3年生存率无明显差异（P〉0．05），恶心呕吐、腹泻、脱发的发生率显著减少（P〈0．01），白细胞减少、口腔炎显著减少（P〈0．05）。结论：与全身化疗比较，肝动脉灌注化疗对治疗胃肠道肿瘤肝转移癌效率高、副作用轻、生存情况明显改善。     

Continuous transarterial infusion chemotherapy with gemcitabine and 5-Fluorouracil for advanced pancreatic carcinoma

Purpose: Pancreatic carcinoma is one of the most malignant tumors of the alimentary system, with relativelyhigh incidence rates. The purpose of this study was to assess the efficacy and safety of two regimens for advancedpancreatic carcinoma: continuous transarterial infusion versus systemic venous chemotherapy with gemcitabineand 5-fluorouracil. Methods: Of the 48 patients with advanced pancreatic carcinoma receiving chemotherapy withgemcitabine and 5-fluorouracil, 24 received the selective transarterial infusion, and 24 the systemic chemotherapy.For the continuous transarterial infusion group (experimental group), all patients received gemcitabine 1000mg/m2,given by 30-minute transarterial infusion, on day 1 of a 4-week cycle for 2 cycles, and a dose of 600 mg/m2 5-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. For the systemic venous group (controlgroup), gemcitabine and 5-fluorouracil were infused through a peripheral vein, a dose of 1000 mg/m2 gemcitabinebeing administrated over 30 min on days 1 and 8 of a 4-week cycle for 2 cycles, and a dose of 600 mg/m25-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. The effectiveness and safety were evaluatedafter 2 cyclesaccording to WHO criteria. Results:The objective effective rate in transarterial group was 33.3%versus 25% in the systemic group, the difference not being significant (P=0.626). Clinical benefit rates(CBR) inthe transarterial and systemic groups were 83.3% and 58.3%, respectively (P=0.014). The means and mediansfor survival time in transarterial group were higher than those of the systemic group (P < 0.005). at the sametime, the adverse effects did not significantly differ between the two groups (P > 0.05). Conclusion: Continuoustransarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate andsurvival time of patients with advanced pancreatic carcinoma, compared with systemic venous chemotherapy.Since adverse effects were limited in the transarterial group, the regimen of continuous transarterial infusionchemotherapy can be used more extensively in clinical practice. A CT and MRI conventional sequence can beused for efficacy evaluation after chemotherapy in pancreatic carcinoma.     

动脉持续灌注化疗与静脉全身化疗治疗中晚期胰腺癌的疗效分析

Objective: To compare the curative effectiveness of continuous transarterial infusion chemotherapy and systemic venous chemotherapy in treating patients with advanced pancreatic cancer, and to evaluate the value of selective continu-ous transarterial infusion chemotherapy in treating advanced pancreatic cancer. Methods: Of the 51 patients with advanced pancreatic cancer receiving chemotherapy with gemcitabine and 5-fluorouracil, 25 patients were treated with selective con-tinuous transarterial infusion chemotherapy, 26 were treated with systemic venous chemotherapy, and curative effective-ness was analyzed retrospectively. Curative effectiveness included tumor volume, clinical benefit response (CBR), acute and subacute toxic reactions of antitumor drugs, survival rate and median survival time. Results: The objective effective rate in transarterial group was 32.0% versus 23.1% in systemic group without any significant difference (P = 0.475). Clinical benefit rates in transarterial group and systemic group were 80.0% and 50.0% respectively (P = 0.025). The 6-, 9-and 12-month accumulated survival rates and median survival time in transarterial group were higher than those of the systemic group (P = 0.002), the differences were statistically significant. However, the adverse reactions between the two groups were not statistically significant. Conclusion: Compared with systemic chemotherapy, continuous transarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate and survival time of patients with advanced pancreatic cancer, it is safe and reliable, and the adverse reactions is less.     

动脉持续灌注化疗与静脉全身化疗治疗中晚期胰腺癌的疗效分析

Objective: To compare the curative effectiveness of continuous transarterial infusion chemotherapy and systemic venous chemotherapy in treating patients with advanced pancreatic cancer, and to evaluate the value of selective continuous transarterial infusion chemotherapy in treating advanced pancreatic cancer. Methods: Of the 51 patients with advanced pancreatic cancer receiving chemotherapy with gemcitabine and 5-fluorouracil, 25 patients were treated with selective continuous transarterial infusion chemotherapy, 26 were treated with systemic venous chemotherapy, and curative effectiveness was analyzed retrospectively. Curative effectiveness included tumor volume, clinical benefit response (CBR), acute and subacute toxic reactions of antitumor drugs, survival rate and median survival time. Results: The objective effective rate in transarterial group was 32.0% versus 23.1% in systemic group without any significant difference (P = 0.475). Clinical benefit rates in transarterial group and systemic group were 80.0% and 50.0% respectively (P = 0.025). The 6-, 9- and 12-month accumulated survival rates and median survival time in transarterial group were higher than those of the systemic group (P = 0.002), the differences were statistically significant. However, the adverse reactions between the two groups were not statistically significant. Conclusion: Compared with systemic chemotherapy, continuous transarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate and survival time of patients with advanced pancreatic cancer, it is safe and reliable, and the adverse reactions is less.     

Hepatic and splenic arterial infusion chemotherapy after transcatheter peripancreatic arterial embolization for patients with inoperable adenocarcinoma of the pancreas]

Thirty-one patients with advanced pancreatic carcinoma and liver metastases were treated by hepatic and splenic arterial infusion chemotherapy after transcatheter peripancreatic arterial embolization. The response rate for these 31 patients was 61.3%, with a mean survival period of 17.8 +/- 3.2 months and a 50% survival period of 12 months. By site of the primary tumor, the response rate for pancreatic head and body carcinoma was 81%, with a mean survival period of 21.6 +/- 4.0 months and a 50% survival period of 17 months, whereas the response rate for pancreatic caudal carcinoma was 20%, with a mean survival period of 6.1 +/- 0.5 months and a 50% survival period of 6 months. We believe that the current chemotherapy is an effective treatment for advanced pancreatic cancer with liver metastases.     

经皮经股动脉植入药盒治疗晚期原发性肝癌的临床疗效

目的探讨药盒在晚期原发性肝癌治疗中的临床价值。方法无外科手术及动脉栓塞指征的８２例晚期原发性肝癌,依据动脉内化疗方式不同,分为两组：Ａ组４２例,采取经皮经股动脉植入药盒,术后经药盒１周或２周化疗１次;Ｂ组４０例,采取每个月１次插管大剂量化疗。结果Ａ、Ｂ两组有效率（ＣＲ＋ＰＲ）分别为３８．１％和１５．０％（Ｐ＜０．０５）。Ａ组６个月、１年、２年生存率分别为６１．９％、２８．６％、９．５％;Ｂ组分别为２０％、５％、０％（Ｐ＜０．０１）。Ａ组患者的生存质量明显改善,消化道反应、肝、胆、骨髓毒性均较Ｂ组低。结论经药盒间断性化疗并配合地塞米松治疗晚期原发性肝癌可明显改善患者的生存质量,提高生存率。