口腔颌面部126例海绵状血管瘤缝扎硬化的疗效分析

目的 观察瘤体分区缝扎硬化治疗颌面部血管瘤的疗效及不良反应。方法 采用瘤体周围及分区交叉缝扎加瘤腔内注射平阳霉素的方法，治疗颌面部海绵状血管瘤126例。平阳霉素术后可重复注射1～6次。结果 随访观察6-36个月，治愈98例，基本治愈26例，有效2例，无无效病例。临床治愈率(包括治愈和基本治愈)为98．4％。结论 分区缝扎硬化治疗海绵状血管瘤操作简便、安全可靠，治愈率高，特别对于唇部、舌前部、颊部易于阻断血流处治疗效果好，具有较好的治疗应用价值。     

口腔颌面部126例海绵状血管瘤缝扎硬化的疗效分析

目的　观察瘤体分区缝扎硬化治疗颌面部血管瘤的疗效及不良反应。方法　采用瘤体周围及分区交叉缝扎加瘤腔内注射平阳霉素的方法,治疗颌面部海绵状血管瘤12 6例。平阳霉素术后可重复注射1～6次。结果　随访观察6～3 6个月,治愈98例,基本治愈2 6例,有效2例,无无效病例。临床治愈率(包括治愈和基本治愈)为98 4%。结论　分区缝扎硬化治疗海绵状血管瘤操作简便、安全可靠,治愈率高,特别对于唇部、舌前部、颊部易于阻断血流处治疗效果好,具有较好的治疗应用价值。     

手术并平阳霉素注射治疗小儿血管瘤和血管畸形

目的:总结手术切除加局部注射平阳霉素治疗小儿血管瘤和血管畸形的临床效果.方法: 本组56例小儿血管瘤,行手术切除大部分瘤体、残余瘤体内注射平阳霉素治疗.术中将配好的平阳霉素分点注射进肿瘤组织内,注射时根据患者的年龄,血管瘤的范围决定注射剂量,一般每一点注射2ml-4ml,以瘤体轻度发白为度,一次注射总量不超过24mg.第一次注射后一期缝合创面,之后每两周注射一次.结果:32例经手术及3次注射治愈(57.14%);13例经3次注射治愈(23.21%);9例经5次注射治愈(16.07%);2例无效 (3.57%),治愈率为96.4%.56例中切口感染2例,经抗感染及交换敷料治愈;注射后引起患儿发热2例,体温37.6℃-38.2℃,经对症处理缓解.未见发生药物过敏或中毒现象.患儿生长发育正常.结论: 平阳霉素注射可以配合手术用于不能全部切除的小儿血管瘤和血管畸形的治疗.     

平阳霉素和地塞米松联合注射治疗颌面部血管瘤52例

目的 观察平阳霉素和地塞米松联合瘤内注射治疗颌面部血管瘤的疗效.方法 采用平阳霉素和地塞米松联合颌面部血管瘤内注射治疗血管瘤52例.结果 治愈48例,基本治愈3例,好转1例,有效率100%.结论 平阳霉素和地塞米松联合瘤内注射治疗颌面部血管瘤是一种安全、可靠、简便、易行且疗效确切的治疗方法为口腔颌面部血管瘤治疗提供了新的途径.     

超声介导治疗肝脏海绵状血管瘤临床研究

目的：报告经ＣＴ和Ｂ超检查确诊的４０例,４３个肝脏海绵状血管瘤,收到良好疗效。方法：在超声引导下平阳霉素瘤内直接注射治疗。结果：肿瘤完全消失１４例;瘤体缩小８０％以上２１例;瘤体缩小５０－８０％３例;失访２例。结论：平阳霉素瘤内用药量小,无明显副作用,治疗后病例随访最长时间３年以上,疗效稳定,提示了超声引导下平阳霉素瘤内直接注射治疗肝脏海绵状血管瘤,其方法简便、安全可靠,效果明显。     

平阳霉素治疗小儿海绵状血管瘤的疗效分析

目的:评价平阳霉素瘤内注射治疗小儿海绵状血管瘤的临床疗效。方法:回顾性分析234例海绵状血管瘤常规瘤体内注射平阳霉素(注射次数1次-6次)后的临床资料。结果:经过3年随访,治愈168例,基本治愈12例,好转45例,无效9例。总有效率96.15%。结论:平阳霉素瘤内注射治疗海绵状血管瘤疗效高,疗程短,是一种简便、安全的有效方法。     

平阳霉素治疗小儿海绵状血管瘤的疗效分析

目的:评价平阳霉素瘤内注射治疗小儿海绵状血管瘤的临床疗效.方法:回顾性分析234例海绵状血管瘤常规瘤体内注射平阳霉素(注射次数1次～6次)后的临床资料.结果:经过3年随访,治愈168例,基本治愈12例,好转45例,无效9例.总有效率96.15%.结论:平阳霉素瘤内注射治疗海绵状血管瘤疗效高,疗程短,是一种简便、安全的有效方法.     

平阳霉素治疗小儿颌面部巨大淋巴管瘤20例

使用平阳霉素局部注射治疗小儿颌面部巨大淋巴管瘤20例,总有效率100％,其中仅1例复发,再经注射后治愈。无明显副作用与并发症。其中单纯瘤体局部注射16例,手术切除主瘤体加术中术后局部注射4例。     

平阳霉素治疗颌面部海绵状血管瘤的疗效探讨

《作者应用抗肿瘤药物平阳霉素治疗颌面部海绵状血管瘤14例,平均范围2.5×3.5cm,部位主要为软腭、口底等,经用药平均44.6mg、6次注射治疗,14例瘤体全部消失,治愈率为100％。此方法适用于颌面部各部位海绵状血管瘤及曾行其他方法治疗失败的病例,且几不影响各部位功能,保持了颌面部的正常形态,不良反应及危险性极小,较其他方法更有其优越性。》该方法简单、方便、安     

平阳霉素治疗小儿浅表血管瘤的观察及护理

目的：探讨平阳霉素瘤体内注射治疗小儿血管瘤的护理对策。方法：对468例小儿血管瘤患者平阳霉素瘤体内注射进行观察评估及护理干预。结果：468例小儿血管瘤患者,治愈336例,基本治愈24例,好转90例,无效18例,总有效率96．15％。结论：平阳霉素瘤体内注射治疗小儿浅表血管瘤安全、有效,护理得当会取得满意效果     

平阳霉素治疗头颈部血管瘤132例临床分析

目的总结平阳霉素瘤内注射治疗头颈部各种血管瘤的疗效。方法收集我科自1996年3月至2003年12月以平阳霉素注射治疗头颈部毛细血管型、海绵状及混合性等血管瘤132例(155个瘤体)的临床资料进行分析。结果经过6个月～8年随访，治愈和基本治愈率为82．57％，好转11．36％，总有效率为93．93％。毛细血管型、海绵状和混合性血管瘤的治愈和基本治愈率分别为84．0％、88．5％、76．1％。发热反应为8．33％。结论平阳霉素治疗毛细血管型、海绵状和混合性血管瘤疗效高，疗程短，是一种简便、安全有效的方法。     

以顺铂为主联合化疗用于头颈部癌的诱导化疗疗效观察

目的 :探讨以顺铂为主的联合化疗在头颈部癌手术前诱导化疗中的价值 ,对手术前诱导化疗的疗效进行了回顾性分析。方法 :1986年～ 1998年 ,对 2 13例头颈部癌进行手术前诱导化疗。以顺铂 平阳霉素 甲氨蝶呤 (DPM方案 )或以顺铂 5 氟脲嘧啶 (DF方案 ) ,用 1～ 2个周期。结果 :诱导化疗后的有效率为 :DPM组为 4 2 4 % ,DF组为 4 5 % ,两组差异无显著性。总的 3年生存率为 5 1 5 % ,5年生存率为 4 4 8%。结论 :以顺铂为主的联合化疗方案对头颈部癌是安全有效的 ,综合治疗对头颈部癌是有效的治疗方法。     

下颌骨旁正中劈开术在中晚期舌鳞癌治疗中的应用

目的 探讨中晚期舌鳞癌术前明确原发灶未侵犯下颌骨,行下颌骨旁正中劈开术在中晚期舌鳞癌联合根治术中的可行性、必要性及其方法.方法 对15例初治的中晚期的舌鳞癌患者,术前行平阳霉素化疗或者顺铂 5-Fu 博莱霉素4～6个周期,化疗结束后,评估原发灶.结果 随访至少5年,1例失访,其中术后2年内原发灶复发2例,术后第3年复发2例.远处转移2例,局部淋巴结复发1例.结论 对于未侵犯下颌骨的中晚期舌鳞癌患者,严格掌握此术式的适应证,行下颌骨旁正中劈开治疗中晚期舌鳞癌是可行的,且有助于彻底的切除原发肿瘤,减少肿瘤的复发,提高患者的生存率.     

Wound bleeding after head and neck surgery

Using our head and neck service database, we reviewed 3,200 surgical procedures performed at our institution over a 7-year period. We identified 54 patients whose surgery was complicated postoperatively by wound bleeding. The procedure most often complicated by wound bleeding was parotidectomy, 1.7% (14 of 510 patients), followed by thyroidectomy, 1.6% (8 of 504 patients), neck dissection combined with other procedures, 1.3% (12 of 885 patients), and neck dissection alone, 1.1% (6 of 534 patients). Bleeding developed in flap donor sites in 2 of 227 patients and followed miscellaneous procedures in 12 others. Thirty-one patients were treated by reexploration in the operating room, 13 had limited exploration on the ward and 10 were observed with no intervention. There was no difference in wound healing between the three treatment groups. However, mean hospital stay was shortest for patients who had wound exploration in the operating room, 6.2 days, for exploration on the ward, 10.8 days, and 18.9 for those that were observed. Drains had no effect on wound healing or mean hospital stay. © 1993 Wiley-Liss, Inc.     

33例头颈部恶性肿瘤患者局部过继免疫治疗的疗效观察

目的评价ＩＬ－２／ＬＡＫ细胞局部过继免疫疗法在头颈部恶性肿瘤治疗中的疗效。方法对３３例头颈部恶性肿瘤患者进行局部过继免疫治疗,采用ＩＬ－２每日１０～２０万单位局部注射,共１０天;于ＩＬ－２治疗的第４～８天同时于局部注射ＬＡＫ细胞１．０×１０８～５．０×１０８／ｄ。结果完全缓解１例,部分缓解６例,好转２０例,稳定６例,治疗总缓解率２１．２％,总有效率８１．８％。治疗后１,２,３年生存率分别为９６．３％、８３．３％、和７５．０％。组织病理学检查证实免疫治疗后肿瘤局部大量ＣＤ３、ＣＤ４阳性Ｔ淋巴细胞浸润。治疗过程中未见严重的毒副作用。结论局部应用ＬＡＫ细胞与ＩＬ－２治疗头颈部恶性肿瘤疗效明显,方法安全。     

Treatment for synchronous and metachronous carcinomas of the head and neck and esophagus

In the past 27 years, 75 patients were found to have separate primary carcinomas of the head and neck and the esophagus. Head and neck tumor was discovered first in 41 patients, synchronously with esophageal tumors in 17 patients, and esophageal tumors were recognized first in 17 patients. Reconstruction by graft after resection of head and neck cancer was necessary in 18 patients and esophagectomy was performed in 62 patients. In eight patients, pharyngeal and esophageal reconstruction was necessary after resection of synchronous and metachronous pharyngeal and esophageal carcinoma. The combined procedure with free tissue transfer was useful for surgical treatment for synchronous or metachronous carcinomas of the head and neck and the esophagus.     

颌面部血管瘤患者瘤腔内注射平阳霉素联合介入栓塞治疗的有效性及安全性研究

目的 探讨颌面部血管瘤患者瘤腔内注射平阳霉素联合介入栓塞治疗的有效性及安全性.方法 选取诊治的颌面部血管瘤患者100例,随机分为对照组与观察组,每组50例,对照组采取瘤腔内注射平阳霉素治疗,观察组采取瘤腔内注射平阳霉素联合介入栓塞治疗,观察两组治疗前、治疗后1个月、3个月、6个月时的血管瘤面积变化,术中及术后并发症发生...     

Daily low-dose carboplatin and standard radiotherapy in unresectable head and neck and lung cancers: a pilot study.

A total of 14 patients with locally advanced and unresectable head and neck (SCCHN) or non small cell lung cancer were treated with a definitive course of radiation therapy with conventional fractionation and 30 mg/m2 carboplatin (CBDCA) given daily as an i.v. infusion during the 1st, 3rd, 5th and 7th weeks of the combined treatment. The planned tumor dose of at least 7000 cGy was reached in all SCCHN patients except 1 (6600 cGy). The 2 NSCLC patients received 6320 and 5980 cGy, respectively. The planned total CBDCA-dose of 600 mg/m2 was administered in all patients. No treatment delays were required in 10 patients. Interruptions for severe mucositis or myelosuppression occurred in 4 patients (28.6%), but in no case did the delay exceed 1 week. Complete response was obtained in 8 patients (57.1%); 7 of the 12 with SCCHN and 1 of the 2 with NSCLC. The other 6 patients achieved a partial response. Granulocytopenia of WHO grade 3 occurred in 1 patient; apart from vomiting and mucositis, toxicities above grade 2 were not observed.     

EUROSCAN, a randomized trial of vitamin A and N-acetylcysteine in patients with head and neck cancer or lung cancer. For the EUropean Organization for Research and Treatment of Cancer Head and Neck and Lung Cancer Cooperative Groups

BACKGROUND: Preclinical evidence suggests that retinoids and antioxidants may prevent or delay the occurrence of cancer in the upper or lower airways, but such effects have not been reliably established in clinical studies. To assess the chemopreventive effects of vitamin A (retinyl palmitate) and N-acetylcysteine, we conducted a large randomized intervention study in patients with head and neck cancer or with lung cancer, most of whom had a history of smoking. METHODS: From June 1988 through July 1994, a total of 2592 patients (60% with head and neck cancer and 40% with lung cancer) were randomly assigned to receive 1) retinyl palmitate (300000 IU daily for 1 year followed by 150000 IU for a 2(nd) year), 2) N-acetylcysteine (600 mg daily for 2 years), 3) both compounds, or 4) no intervention. All statistical tests were two-sided. RESULTS: Of the patients, 93.5% had smoked tobacco at sometime in their lives (and 25% continued to smoke after cancer diagnosis). After a median follow-up of 49 months, 916 patients were reported with an event (recurrence, second primary tumor, or death). No statistically significant difference was observed in overall survival or event-free survival between patients who received retinyl palmitate and patients who did not. Similarly, no difference was seen in overall survival or event-free survival between patients who received N-acetylcysteine and patients who did not. There was a lower incidence of second primary tumors in the no intervention arm, but the difference was not statistically significant. CONCLUSION: A 2-year supplementation of retinyl palmitate and/or N-acetylcysteine resulted in no benefit-in terms of survival, event-free survival, or second primary tumors-for patients with head and neck cancer or with lung cancer, most of whom were previous or current smokers.     

Effective targeting of solid tumors in patients with locally advanced cancers by radiolabeled pegylated liposomes.

The biodistribution and pharmacokinetics of (111)In-DTPA-labeled pegylated liposomes (IDLPL) were studied in 17 patients with locally advanced cancers. The patients received 65-107 MBq of IDLPL, and nuclear medicine whole body gamma camera imaging was used to study liposome biodistribution. The t(1/2beta) of IDLPL was 76.1 h. Positive tumor images were obtained in 15 of 17 studies (4 of 5 breast, 5 of 5 head and neck, 3 of 4 bronchus, 2 of 2 glioma, and 1 of 1 cervix cancer). The levels of tumor liposome uptake estimated from regions of interest on gamma camera images were approximately 0.5-3.5% of the injected dose at 72 h. The greatest levels of uptake were seen in the patients with head and neck cancers [33.0 +/- 15.8% ID/kg (percentage of injected dose/kg)]. The uptake in the lung tumors was at an intermediate level (18.3 +/- 5.7% ID/kg), and the breast cancers showed relatively low levels of uptake (5.3 +/- 2.6% ID/kg). These liposome uptake values mirrored the estimated tumor volumes of the various tumor types (36.2 +/- 18.0 cm3 for squamous cell cancer of the head and neck, 114.5 +/- 42.0 cm3 for lung tumors, and 234.7 +/- 101.4 cm3 for breast tumors). In addition, significant localization of the liposomes was seen in the tissues of the reticuloendothelial system (liver, spleen, and bone marrow). One patient with extensive mucocutaneous AIDS-related Kaposi sarcoma was also studied according to a modified protocol, and prominent deposition of the radiolabeled liposomes was demonstrated in these lesions. An additional two patients with resectable head and neck cancer received 26 MBq of IDLPL 48 h before undergoing surgical excision of their tumors. Samples of the tumor, adjacent normal mucosa, muscle, fat, skin, and salivary tissue were obtained at operation. The levels of tumor uptake were 8.8 and 15.9% ID/kg, respectively, with tumor uptake exceeding that in normal mucosa by a mean ratio of 2.3:1, in skin by 3.6:1, in salivary gland by 5.6:1, in muscle by 8.3:1, and in fat by 10.8:1. These data strongly support the development of pegylated liposomal agents for the treatment of solid tumors, particularly those of the head and neck.