共查询到20条相似文献,搜索用时 15 毫秒
1.
State of the art treatment for invasive bladder cancer is cystectomy. Intensive clinical investigation has been performed
in the last years about the role of neoadjuvant and adjuvant chemotherapy. Although neoadjuvant treatment seems not to increase
long-term survival, it seems to play a role in the possibility of bladder preservation strategies. Adjuvant chemotherapy,
in high-risk patients, seems to improve disease-free survival and time to progression. Nevertheless, new prospective studies
should be performed to clarify its role in improving survival.
相似文献
2.
《Expert review of anticancer therapy》2013,13(6):821-830
Muscle-invasive bladder cancer is a deadly disease that often requires more than radical surgery for optimal management. The best level one evidence supports the use of neoadjuvant methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) chemotherapy followed by surgery. There remains controversy, however, with some continuing to argue in favor of selective adjuvant chemotherapy only in the highest risk patients. Certain patients and situations argue in favor of a surgery-first approach, with selective chemotherapy in an adjuvant setting. There is a need for better markers for disease risk and progression in advanced bladder cancer to identify those who would benefit the most from aggressive, multimodal therapy. Further studies are needed to address the ongoing questions that remain in the management of this disease. 相似文献
3.
目的探讨化疗联合调强放疗在食管癌治疗中的应用价值。方法按照治疗方案的不同将120例食管癌患者分为对照组和观察组,各60例。全部患者均接受5-氟尿嘧啶+顺铂化疗,对照组患者同时接受常规放疗,观察组患者同时接受调强放疗。比较两组患者的近期疗效。结果观察组患者的治疗总有效率为88.33%(53/60),明显高于对照组患者的58.33%(35/60),差异有统计学意义(P﹤0.01)。两组患者均发生了放疗相关不良反应,包括放射性食管炎、放射性肺炎、骨髓抑制;观察组患者的放疗相关不良反应的发生率均明显低于对照组,差异均有统计学意义(P﹤0.01)。结论食管癌患者在接受化疗的同时接受调强放疗,既可以提高近期疗效,又可以减少放射不良反应的发生,治疗安全性较高。 相似文献
4.
食管癌化疗的演变及其在综合治疗中的作用 总被引:10,自引:0,他引:10
本文评述食管癌化疗的前景与困难.全身化学治疗有可能提高食管癌患者缓解率,延长生存期和改善生活质量.联合化疗治疗食管癌有明显优越性.顺铂 氟尿嘧啶(加或不加醛氢叶酸)认为是最佳联合化疗药物,对食管鳞癌的有效率为42%~66%,对食管腺癌的有效率为27%~48%.评价较新的化疗药物,包括紫杉醇类和喜树碱类(如伊利替康)可有助于选择更为有效和较好耐受的全身治疗方案.由于单用手术或单用放疗的患者预后较差,推动食管癌的综合治疗.目前临床试验有术前(新辅助)化疗,术前同时联合化-放疗,或对局部区域病变单用化-放疗,以及对有高复发危险的患者行术后(辅助)化疗,将有助于为食管癌患者提供最佳的治疗方案. 相似文献
5.
6.
7.
伊立替康二线治疗晚期食管癌的临床观察 总被引:3,自引:0,他引:3
目的:观察伊立替康单药二线治疗23例晚期食管癌患者的临床获益率、中位生存期和毒性反应.方法:采用伊立替康单药方案治疗(140mg/m2,静滴90分钟,第1天;120mg/m2,第8天,每3周给药).化疗2-4周期后观察临床获益率、中位生存期和毒性反应.结果:23例患者中,PR 2例(8.7%),SD 11例(47.8%),临床获益率56.5%.中位PFS为2.3个月,中位生存期为5.7个月.主要毒副反应,Ⅲ-Ⅳ度消化道反应5例(21.7%),其中腹泻3例.Ⅲ-Ⅳ度血液学毒性4例(17.4%).结论:对于晚期复发进展的食管癌患者,伊立替康单药方案治疗是安全、有效的二线治疗方案. 相似文献
8.
P. Ghaneh R. SmithC. Tudor-Smith M. RaratyJ.P. Neoptolemos 《European journal of surgical oncology》2008
Pancreatic cancer is one of the major causes of cancer death. The majority of patients present with advanced disease and only 10–15% of patients can undergo resection. Survival after curative surgery is poor, as recurrences occur either locally or in the liver. Adjuvant therapy aims to improve survival and control systemic disease. 相似文献
9.
Miyanishi K Ishiwatari H Hayashi T Takahashi M Kawano Y Takada K Ihara H Okuda T Takanashi K Takahashi S Sato Y Matsunaga T Homma H Kato J Niitsu Y 《Japanese journal of clinical oncology》2008,38(4):268-274
Background: We previously reported that arterial infusion chemotherapy improvedthe response rate and survival of the patients with pancreaticcancer at advanced stages in an open trial. We conducted a PhaseI trial of arterial infusion chemotherapy with gemcitabine and5-fluorouracil for advanced pancreatic cancer after vascularsupply distribution via superselective embolization. Methods: Patients were treated after arterial embolization for hemodynamicchange to restrict the blood flow into the pancreas (mainlyto the great pancreatic artery and the caudal pancreatic artery).Arterial infusion chemotherapy consisted of gemcitabine in dosesthat were increased from 600 to 1000 mg/m2 in subsequent cohortson Day 1 plus continuous infusion of 5-fluorouracil 300 mg/m2/dayon Days 1–5 every 2 weeks. Result: Twelve patients were enrolled. The maximum tolerated dose ofgemcitabine was determined to be Level 3 (1000 mg/m2). Onlyvery mild hematological and non-hematological toxicities werenoted. The overall response rate was 33.3%. The median survivaltime was 22.7 (95% CI; 9.5–24.5) months and the 1- and2-year overall survival rates were 83.3 and 25.0%, respectively. Conclusion: Arterial infusion chemotherapy using 1000 mg/m2 gemcitabineon Day 1 and 300 mg/m2/day 5-fluorouracil on Days 1–5every 2 weeks warrants a Phase II study. 相似文献
10.
Mooney MM 《Journal of surgical oncology》2005,92(3):230-238
The poor outcome associated with surgical resection alone for most patients with locoregional esophageal cancer has generated intensive investigation of combined-modality treatment approaches that include systemic chemotherapy. This review discusses the current role of chemotherapy in the treatment of patients with adenocarcinoma of the esophagus, given in either the pre-operative (neoadjuvant) or post-operative (adjuvant) setting compared to surgery alone, highlighting the results of large, randomized clinical trials that included patients with adenocarcinoma of the esophagus as well as some of the approaches being evaluated with novel therapies in earlier phase clinical trials. Although no definitive recommendations for pre-operative or post-operative treatment can be made for patients with adenocarcinoma of the esophagus based on outcomes reported in randomized clinical trials performed to date, the results from these trials suggest chemotherapy or chemoradiation in the peri-operative period may have benefit, especially in certain sub-groups. Newer, more effective agents are needed as well as methods to identify which tumors will respond to therapy. Improvement in outcomes for patients with this disease will require rigorous evaluation of newer multi-modality regimens in well-designed and appropriately powered clinical trials. 相似文献
11.
Neoadjuvant treatments for locally advanced,resectable esophageal cancer: A network meta‐analysis 下载免费PDF全文
Kelvin K. W. Chan Ronak Saluja Keemo Delos Santos Kelly Lien Keya Shah Gemma Cramarossa Xiaofu Zhu Rebecca K.S. Wong 《International journal of cancer. Journal international du cancer》2018,143(2):430-437
The relative survival benefits and postoperative mortality among the different types of neoadjuvant treatments (such as chemotherapy only, radiotherapy only or chemoradiotherapy) for esophageal cancer patients are not well established. To evaluate the relative efficacy and safety of neoadjuvant therapies in resectable esophageal cancer, a Bayesian network meta‐analysis was performed. MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched for publications up to May 2016. ASCO and ASTRO annual meeting abstracts were also searched up to the 2015 conferences. Randomized controlled trials that compared at least two of the following treatments for resectable esophageal cancer were included: surgery alone, surgery preceded by neoadjuvant chemotherapy, neoadjuvant radiotherapy or neoadjuvant chemoradiotherapy. The primary outcome assessed from the trials was overall survival. Thirty‐one randomized controlled trials involving 5496 patients were included in the quantitative analysis. The network meta‐analysis showed that neoadjuvant chemoradiotherapy improved overall survival when compared to all other treatments including surgery alone (HR 0.75, 95% CR 0.67–0.85), neoadjuvant chemotherapy (HR 0.83. 95% CR 0.70–0.96) and neoadjuvant radiotherapy (HR 0.82, 95% CR 0.67–0.99). However, the risk of postoperative mortality increased when comparing neoadjuvant chemoradiotherapy to either surgery alone (RR 1.46, 95% CR 1.00–2.14) or to neoadjuvant chemotherapy (RR 1.58, 95% CR 1.00–2.49). In conclusion, neoadjuvant chemoradiotherapy improves overall survival but may also increase the risk of postoperative mortality in patients locally advanced resectable esophageal carcinoma. 相似文献
12.
目的:用系统评价的方法对新辅助化疗治疗食管癌的疗效进行评估,从而为临床决策提供参考.方法:计算机检索PubMed,EMBASE,Cochrane Library,中国期刊全文数据库,中国生物医学文献数据库,中文科技期刊数据库等资源,搜集2010-04前发表的有关新辅助化疗治疗食管癌的随机对照试验(RCTs),按Cochrane系统评价手册5.0.2的文献质量评价办法评价纳入研究的方法学质量,而后提取有效数据并采用RevMan 5.0.17软件进行Meta分析.结果:共纳入11个随机对照试验,包括2 343例患者.Meta分析结果显示,与单纯手术性比,新辅助化疗可以提高根治切除率[RR=1.12,95%CI(1.04~1.22)]和5年生存率[RR=1.39,95%CI(1.15~1.68)]而两组间3年生存率[RR=1.18,95%CI(0.94~1.49)]、疾病进展时间[MD=0.61,95%CI(-4.87~6.10)]及术后并发症差异无统计学意义[RR=1.21,95%CI(0.83~1.76)].结论:食管癌术前进行新辅助化疗可以提高根治切除率和5年生存率,使患者受益. 相似文献
13.
14.
15.
16.
目的:观察DDP加5-FU联合放疗治疗中晚期食管癌的近期疗效和毒副反应。方法:43例病人随机分为试验组和对照组,试验组予DDP加5-FU同期化疗联合放疗,对照组单纯放疗,对比观察两组病人的近期疗效和毒副反应并作统计学分析。结果:试验组有效率89.2%,对照组有效率60%,有显著差异。结论:DDP加5-FU联合放疗可有效治疗中晚期食管癌,缓解症状,近期疗效显著,且毒副作用较小,值得进一步研究。 相似文献
17.
28例中晚期食管癌放疗联合PF方案同期化疗近期疗效观察 总被引:2,自引:0,他引:2
目的:观察DDP加5-FU联合放疗治疗中晚期食管癌的近期疗效和毒副反应。方法:43例病人随机分为试验组和对照组,试验组予DDP加5-FU同期化疗联合放疗,对照组单纯放疗,对比观察两组病人的近期疗效和毒副反应并作统计学分析。结果:试验组有效率89.2%,对照组有效率60%,有显著差异。结论:DDP加5-FU联合放疗可有效治疗中晚期食管癌,缓解症状,近期疗效显著,且毒副作用较小,值得进一步研究。 相似文献
18.
High infiltration of tumor‐associated macrophages is associated with a poor response to chemotherapy and poor prognosis of patients undergoing neoadjuvant chemotherapy for esophageal cancer 下载免费PDF全文
Keijiro Sugimura MD Hiroshi Miyata MD Koji Tanaka MD Tsuyoshi Takahashi MD Yukinori Kurokawa MD Makoto Yamasaki MD Kiyokazu Nakajima MD Shuji Takiguchi MD Masaki Mori MD Yuichiro Doki MD 《Journal of surgical oncology》2015,111(6):752-759
19.
目的:研究雷替曲塞联合铂类在晚期食管癌中的疗效及安全性。方法:2010年8月至2013年8月共28例晚期食管癌患者在一线氟尿嘧啶类药物化疗失败后,以雷替曲塞联合铂类为二线方案化疗,其中雷替曲塞 3mg/m2,静脉滴注15分钟,每21天一个周期。两周期后评价疗效。结果:27例患者可评价疗效,CR 1例(3.7%),PR 7例(25.9%),SD 10例(37.0%),PD 9例(33.3%),中位无进展生存时间4.6个月。结论:雷替曲塞联合铂类治疗晚期食管癌疗效较好,不良反应能够耐受,值得临床推广使用。 相似文献
20.
结直肠癌辅助化疗的新观念和新进展 总被引:7,自引:0,他引:7
辅助化疗是结直肠癌综合治疗中的重要组成部分,也是防治远处转移的主要手段.近年来,结直肠癌辅助化疗涌现了许多新观念,取得了许多新进展.本文对此进行全面阐述,以指导临床上合理应用辅助化疗,提高结直肠癌的疗效,延长患者的生存期,改善生活质量. 相似文献