介入动脉化疗加放射治疗鼻咽癌的近期疗效

目的 探讨经颈动脉灌注化疗药物治疗加放疗对鼻咽癌的疗效.方法 22例患者经临床(包括鼻咽镜检)、影像学(CT、MR)和病理学检查确诊为鼻咽癌,经颈外动脉介入化疗后加放射治疗.化疗药物为阿霉素(ADM)或吡柔比星、5-氟尿嘧啶(5-FU)和顺铂(DDP)或卡铂(CBP).同时随机选择同期单纯放疗的25例作为对照,比较其疗效.结果 介入组总有效率为100.0%,其中CR为90.9%(20/22),对照组总有效率为100.0%,其中CR为68.0%(17/25),两组分别比较差异有统计学意义(P＜0.05).结论 介入动脉化疗后加放射治疗能显著提高鼻咽癌治疗的疗效.     

动脉化疗栓塞治疗晚期卵巢癌

目的 探讨经动脉化疗栓塞治疗晚期卵巢癌的疗效.资料与方法 对48例晚期卵巢癌患者行髂内动脉、卵巢动脉化疗栓塞,其中Ⅲ期26例、Ⅳ期22例,灌注药物剂量分别为:顺铂(DDP)50 mg/m~2或卡铂400～600 mg、丝裂霉素(MMC)6～10 mg.栓塞剂选用明胶海绵.在介入术前3 h静脉注射5-氟尿嘧啶(5-FU)1000～1250 mg.结果 采用单纯介入治疗者总有效率69.2%(9/13),完全缓解(CR)4例,部分缓解(PR)5例,稳定(SD)3例,进展(PD)1例,患者2年生存率46.2%(6/13).采用介入+手术治疗者总有效率91.4%(32/35),CR21例,PR 11例,SD 3例,患者2年生存率71.4%(25/35).无严重并发症发生.结论 经导管动脉化疗栓塞治疗晚期卵巢癌疗效肯定,为综合治疗晚期卵巢癌增加了新的治疗手段,并为无法手术者提供了二期手术机会.     

Ⅲ期非小细胞肺癌的综合治疗

目的:探讨支气管动脉化疗栓塞结合同步放疗、静脉化疗治疗Ⅲ期非小细胞肺癌(NSCLC)的疗效。方法:143例Ⅲ期NSCLC患者分为2组,对照组71例,化疗与放射治疗同步进行;介入组72例,采用支气管动脉化疗栓塞,第2天行放疗,介入治疗2个周期。放疗总剂量60～70Gy,6～7周完成。所有患者3～4周后采用长春瑞滨、顺铂(NP)方案,共化疗2～4个周期。结果:2组全部完成治疗计划。介入组完全缓解(CR)占37.5%,部分缓解(PR)占45.8%,有效率83.3%;对照组CR占23.9%,PR占39.4%,有效率63.3%。介入组中位生存期为22.6个月,对照组为14.5个月。1、2、3年生存率介入组为78.6%、44.3%、23.5%,对照组为63.2%、33.4%、14.5%。介入组明显高于对照组,差异有统计学意义(P<0.05)。无严重并发症发生。结论:经支气管动脉化疗栓塞结合放疗、静脉化疗治疗Ⅲ期NSCLC能延长患者的中位生存期,提高生存率,具有较好的临床疗效。     

中晚期中心型肺癌的综合治疗

目的:探讨支气管动脉化疗栓塞结合同步放疗、静脉化疗治疗中心型肺癌的疗效。方法:156例中晚期中心型肺癌患者分为两组,放化疗组77例,化疗与放射治疗同步进行。介入组79例,采用支气管动脉化疗栓塞,第二天行放疗,介入2个周期。放疗总剂量60～70G,6～7周完成。所有患者3～4周后采用长春瑞滨、顺铂或依托铂苷、顺铂方案,共化疗2～4个周期。结果:两组病例全部完成治疗计划。介入组CR 39.2%,PR 46.7%,有效率(CR+PR)85.9%,中位生存期为23.3个月,1、2、3年生存率为79.7%、49.4%、26.6%。对照组CR 25.9%,PR 38.9%,有效率(CR+PR)64.8%,中位生存期为15.8个月,1、2、3年生存率为63.6%、31.2%、13.0%。介入组与对照组之间疗效差异有统计学意义(P<0.05)。无严重并发症发生。结论:经支气管动脉化疗栓塞结合放疗、静脉化疗治疗中心型肺癌能延长患者的中位生存期,提高患者的生存率,具有较好的临床疗效。     

介入、放疗及静脉化疗对非小细胞肺癌疗效的对比分析

目的　通过对比分析中晚期非小细胞肺癌几种非手术治疗的效果 ,提出合理的治疗方法。方法　收集 2 6 0例非小细胞肺癌 ,分属于 4组 :①单纯介入治疗 (动脉灌注 )组 ;②单纯放射治疗组 ;③全身静脉化疗组 ;④介入加放疗组。均有治疗前后X线胸片检查对比。结果　中晚期非小细胞肺癌的介入、放疗、全身化疗及介入加放疗的近期有效率分别是 75 %、6 5 %、5 0 %和 90 %。单纯介入、放疗不能预防和控制病变的转移 ,虽然全身化疗的近期有效率相对较低 ,但在治疗过程中远处转移发生率也相对较低 ,介入加放疗对控制局部原发病灶较为理想。结论　对中晚期非小细胞肺癌的非手术治疗 ,介入、放疗和全身化疗都是有效的治疗方法 ,它们有互补作用 ,不能互相取代。合理的综合运用 ,即序贯疗法化疗—介入—放疗—化疗 ,可望能得到更好的疗效。     

缓释化疗粒子与三维适形放疗治疗晚期直肠癌的疗效比较

目的比较5-FU化疗粒子与三维适行放疗治疗晚期直肠癌的疗效。方法将84例晚期直肠癌患者随机等分为两组,A组行5-FU化疗粒子植入术;B组行三维适形放疗,分别观察1年生存率、并发症发生率及有效率。结果 (1)两组1年生存率分别为57.16%、45.83%;A组生存率高于B组,差异有统计学意义(χ2=7.29;P<0.05);(2)两组并发症发生率分别为14.29%、28.57%,A组并发症发生率低于B组,差异有统计学意义(χ2=6.81;P<0.05);(3)两组治疗后有效率分别为88.09%、76.19%,A组有效率高于B组,差异有统计学意义(χ2=7.42;P<0.05)。结论 5-FU化疗粒子植入术治疗晚期直肠癌疗效较好。     

支气管动脉碘化油化疗栓塞肺癌

目的 探讨支气管动脉碘化油化疗栓塞治疗肺癌的可行性和疗效.方法 化疗栓塞33例肺癌,其中鳞癌20例,腺癌8例,小细胞癌1例,未定型4例;Ⅱ期5例,ⅢA期13例,ⅢB期11例,Ⅳ期4例.行支气管动脉插管,经导管灌入CDDP 80～100 mg、MMC 10 mg后,再将ADM 30 mg和2～10 ml碘化油(平均4.65 ml)混悬剂化疗栓塞.另外3例化疗栓塞后1周手术切除肿瘤.结果 化疗栓塞组CR2例,PR 21例,S 9例,P 1例,有效率(CR PR)69.7%.化疗栓塞后手术病理见肿瘤细胞大量坏死.未出现脊髓损伤等严重并发症.结论 本法治疗肺癌近期疗效较好,在良好的支气管动脉数字减影血管造影基础上谨慎进行.     

顺铂微球联合栓塞化疗治疗复发或晚期鼻咽癌

1993年4月至1994年1月对14例放疗后局部复发或未控制和3例初治晚期鼻咽癌用顺铂微球联合 PBF(DDP,BLM,5-Fu)进行颌内动脉栓塞化疗。结果:CR2例,PR13例,MR1例,NC1例,总有效率(CR+PR)88.24%;3例初治晚期病例均为 PR。本文还对颌内动脉栓塞化疗的副作用,并发症等进行了讨论。     

动脉置泵靶向化疗在晚期胃癌中的应用

目的 探讨动脉内置泵靶向化疗对晚期胃癌的疗效.方法 对47例无法切除的晚期胃癌采用动脉置泵灌注化疗,化疗方案:氟尿嘧啶(5-FU)500mg/m2,吡柔比星(MMC)10mg/m2,羟喜树碱(HPT)20mg/m2,每周2次,2周为1个疗程,休息3周后重复,共2～3个疗程.结果 完全缓解(CR)1例,部分缓解(PR)2...     

吉西他滨、顺铂动静脉联合化疗治疗晚期非小细胞肺癌的近期疗效分析

目的 探讨选择性经支气管动脉灌注(BAI)吉西他滨、顺铂结合吉西他滨静脉化疗治疗晚期非小细胞肺癌(NSCLC)的近期疗效;方法 随机选择60例经病理证实的原发性晚期NSCLC初治病例行GP方案(吉西他滨 1 000 mg/m2 BAI d1,顺铂 50 mg/m2 BAI d1;吉西他滨1 000 mg/m2 静脉滴注 d8)治疗.结果 在可评价的60例患者中,CR 3例,PR 35例,SD 17例,PD 5例,总有效率63%.其中腺癌22例,有效率45%;鳞癌38例,有效率74%(P ＜ 0.05);中央型37例,有效率73%;周围型23例,有效率48%(P ＜ 0.05).结论 GP方案经动静脉联合化疗治疗晚期NSCLC的近期效果确切,疗效与肿瘤的解剖部位、病理分型有明显相关性.     

嗅神经母细胞瘤的化疗分析

目的分析影响嗅神经母细胞瘤化疗的因素并探讨嗅神经母细胞瘤的化疗方案。方法回顾性地分析我科1993年3月，2004年6月收治的4例行化疗的嗅神经母细胞瘤病人的临床资料，包括就诊时年龄、性别、病程、Kadish分期、组织病理学分级、治疗方式，预后，并对文献进行回顾。结果男4例，平均年龄31．5岁，Kadish分期：均为C期。组织病理学分级：2级1例，3级2例，4级1例。化疗药物4例舍有足叶乙甙、3例含有铂类药物。化疗在首次治疗中应用1例（病理2级随访6月，带瘤生存），挽救治疗中应用3例（2例病理3级分别随访48月、6月无瘤生存，1例病理4级随访12月带瘤生存）。结论嗅神经母细胞瘤治疗采用化疗有效，组织病理学分级影响肿瘤对化疗敏感性．化疗宜采取含铂类厦足叶乙甙的多种药物。     

动脉化疗在妇科恶性肿瘤多途径化疗中的价值探讨

目的：通过４种化疗方法的分析比较,了解动脉化疗在妇科恶性肿瘤化疗中的价值。材料与方法：４０例妇科恶生肿瘤分成两组（卵巢肿瘤组和子宫肿瘤组）,按４种不同途径行反复多次化疗,包括４２次单一静脉化疗,１２４次静脉加腹腔化疗法,１０６次单一动脉化疗,４８次动脉化疗后再行静脉加腹腔联合化疗。结果：对卵巢恶性肿瘤采用多途径联合用药化疗近期疗效最佳（Ｐ〈０．０１）,单一动脉化疗与加腹腔联合化疗比较无差异（Ｐ〉０     

Chemotherapy of ovarian carcinoma

It can be demonstrated by giving examples that the response of ovarial carcinomas to chemotherapy is most variable. At the Gynecologic Hospital of the University of Freiburg, the prognosis of extensive ovarial carcinomas has improved during the past years, possibly due to a more consequent and aggressive chemotherapy. The primary operations, however, have become more radical, too, but this depends directly on the histological type and especially the degree of differentiation of the tumor. The review of literature shows that a conventional chemotherapy today is expected to produce a remission rate of 40% and that it has not been clarified yet if a combination of different cytostatic drugs is finally superior to monotherapy. Chemotherapy with cisplatine seems to bring about more remissions, especially more total remissions. But the criterion of remission rate is not sufficient to judge the clinical practicability of a chemotherapy. One has to take into consideration the unjudgeable cases, the patients breaking up therapy, and the cases in which chemotherapy in this form cannot be performed or continued. Under this criteria, too, modern chemotherapy with cisplatine seems to be superior to former chemotherapies. On the other hand, chemotherapy of progressive and recurrent ovarial carcinomas is still completely unsatisfactory. Another unsolved problem is the maintenance of remission, and it should be investigated if radiotherapy can play an important role in this connection. A second-look operation is only indicated if a remission is clearly demonstrated, but these cases have the same good prognosis as patients submitted to primary radical surgery. The crucial point is therefore the first response of ovarial carcinomas to chemotherapy, and this depends on different clinical and morphological factors. Today a biochemical evaluation of chemoresistance is probably possible by modern methods. This is being investigated in a prospective study.     

Potentiation of Chemotherapy by Low-level Ultrasound

Summary

We have performed in vitro and in vivo tests to determine whether ultrasound (US) at levels lower than previously investigated by others could still potentiate chemotherapeutic cell killing. Positive results were obtained with adriamycin and diaziquone. Two types of low-level US were effective: tone-burst US (10% duty cycle, 1·765 MHz, I_SATA = 0·25 W/cm²), and pulsed US (2·5 MHz centre frequency, 1 kHz repetition frequency, MPa-level pressure amplitudes), distributed uniformly over the biological target. These US beams were non-cytotoxic and produced negligible temperature elevation. Statistically significant US-induced increases in drug cytotoxicity were observed in CHO and MCF-7 WT but not V79 cells for 1-h drug exposures at several drug concentrations. The effects of combined drug and US treatments in vivo were studied by measuring post-treatment volume changes in uterine cervical squamous cell carcinoma implanted in the cheek pouch of the Syrian hamster. A statistically significant US-drug synergy in tumour volume reduction was observed with adriamycin and diaziquone.