吃主食护大肠

英国剑桥大学最近在一项研究中,分析了10多个国家的人的饮食习惯和癌症之间的关系,结果发现,食用淀粉类食物越多,小肠、结肠和直肠癌的发病率越低.比如,以肉类食物为主食的澳大利亚人,结肠癌发病率是以淀粉类食物为主食的中国人的4倍.     

凉菜拌出夏日风情

不知不觉又进入了夏季,南方的潮湿,北方的燥热,常常使人食欲不振,精神委靡,尤其是对于康复期的病友来说,怎一个"热"字了得.夏季的饮食调养,应选择清凉爽口、少油腻、易消化的食物.这时从配角一跃成为主角的凉菜就闪亮登场了,不论生拌、热炝,每道菜都做足了开胃功夫,它们少油,少盐,对我们的健康大有裨益;省时省力,让我们减轻在厨房的劳动强度.只要掌握烹饪技巧,制作起来还是很简单的.     

过敏体质,怎么吃?

什么是过敏呢?过敏反应又称作变态反应,是患者身体对一种或多种物质的过强反应.其主要机制是由于过敏性素质患者的体内产生了过多的过敏抗体——免疫球蛋白E,它和环境中的过敏原相互作用,刺激机体产生和释放某些过敏介质,导致不同组织的损伤,继而产生各种症状.     

文艺汇演群星璀璨

2006年1月8日,中国抗癌协会癌症康复会在"北京展览馆剧场"圆满成功地举办了"阿斯利康首届全国癌症康复者文艺汇演--生命恋歌".这次文艺汇演有26个省、市上报节目50多个,经筹备组认真筛选,选出正式参加演出的节目16个,特邀节目3个,出演的癌症患者近300人.     

钻石之光--山药

"每个人都能在自家的后院找到钻石",有人借用此言,把山药比做养生的钻石. 山药是一种薯科植物,它的根茎垂直而颀长,往往盈尺,生长在坚硬的山冈的土质中,旋转攀缘.阳光下,山药的叶子很美,颜色从浓到浅,绿得缤纷,但被我们称之为钻石的是它营养丰富的块状根茎.山药的外观看上去粗糙,细小密布的根须如刺如须,但削了皮,却洁白得如水生荸荠,分泌一些透明的黏液,柔滑得抓它不住,仿佛泥鳅从手中挣脱.     

Benefit of adjuvant chemoradiotherapy in patients with pathologically lymph node-positive and locally advanced gastric cancer

Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that could benefit from adjuvant CRT.Methods All eligible patients were divided into the CRT group and ChT group.We assessed the survival outcomes and patterns of recurrence for each group,and determined the prognostic factors for survival by performing Cox proportional risk regression analyses.Results A total of 192 gastric cancer patients were included in the study.The estimated 3-year and 5-year disease-free survival(DFS)probabilities in the CRT and ChT groups were 52.9%vs.36.7%(P=0.024)and 41.2%vs.31.1%(P=0.148),respectively,and the estimated 3-year and 5-year overall survival(OS)probabilities were 82.4%vs.70.0%(P=0.044)and 52.0%vs.35.6%(P=0.022).Patients in the CRT group had a lower risk of locoregional recurrence than those in the ChT group(20.6%vs.34.4%;P=0.031).The subset analyses revealed that patients with stage N1–2 disease were more likely to benefit from adjuvant CRT than from adjuvant ChT(DFS:53.1%vs.36.4%;P=0.039;OS:53.1%vs.38.6%;P=0.036).Conclusion For locally advanced gastric cancer patients with LN+,adjuvant CRT showed superior survival benefits compared with adjuvant ChT alone.Patients with N1–2 achieved better survival from adjuvant CRT.     

苦参碱对HepG2细胞杀伤作用及机制研究

Objective:To investigate the death mode of human hepatoma cells exposed to matrine and the role of glutathione (GSH) and cytochrome c.Methods:The MTT test and Cell Death Detection ELISA were used to identify cell death mode and viability of cells exposed to matrine.The volume of intracellular GSH was detected by GSH reductase.Finally Western blotting was chosen to analyze the expression of cytochrome c and Caspase-9 in HepG2 cells treated by matrine.Results:The apoptotic cell death induced by matrine in Hep G2 cells dramatically increased in the time-,dose-dependent manner.Matrine can exhaust intracellular GSH effectively to change the redox state in cells.Furthermore it affect the cytotoxicity of matrine.Results of Western blotting showed that matrine induced the release of cytochrome c from mitochondria to cytoplasm,and then stimulate the cleavage of Cespese-9 in a time-dependent manner.Conclusion:Matrine induced apoptosis in Hep G2 cells through the mitochondrial pathway,and oxidative stress via depletion of GSH is directly involved in the apoptotic process.     

熏烤煎炸不安全

据说人类发现用火是由于森林起火烧焦了动物而引起的,从那时起,便尝到了烧烤味道的鲜美.时至今日,熏烤煎炸食品气味香,味道美,仍不免会令人垂涎三尺,颇受嘴馋的人或一些儿童、少女青睐,从而造就许多中国人有喜食这类食品的习惯.这类食品如在聚餐酒桌上品尝助兴,少量吃点在所难免,如果大量贪食则可能会对健康不利.化学家在研究癌症病因时,发现一种很强的致癌物质苯并芘,它属于多环芳烃类化合物,与熏烤煎炸食物有关,并引起人们的关注.     

肺癌放疗新技术

肺癌是危害人类生命的最主要的癌肿,是名副其实的"癌王",特别是在发达国家更是如此.简单地说美国男性死于恶性肿瘤患者中约每3人中有1例是肺癌,女性中每4人中有1人是肺癌.中国随着城市化进度的加快和吸烟人群的增多,肺癌患者会越来越多.笔者在美国最著名的癌症医院--德州安德森肿瘤中心做客座教授期间接触了来自世界各地的放疗科医生,他们都在努力研究如何延长肺癌患者的生存期,提高生存质量.下面介绍一下这方面的最新技术.     

Clinical study of three dimensional conformal radiotherapy combined with intracavitary brachytherapy in the treatment of cervical cancer

Objective  

The aim of our study was to evaluate the outcome and complications of cervical cancer patients undergoing conventional intracavitary brachytherapy (ICBT) treated with 3D-conformal radiotherapy (3DCRT).     

弥漫性恶性胸膜间皮瘤三维适形放疗的近期疗效及其与改良的半胸照射放疗技术比较的研究

ObjectiveTo observe the effects of the new technique of flexible 3D-conformal radiotherapy with combination of photon and electron (3DCRT) in the treatment of the patients with diffuse malignant pleural mesothelioma (MPM),and carry out the comparative study between flexible 3DCRT and hemithoracic conventional radiotherapy (CRT).MethodsFrom January 2004 to October 2007,8 patients with MPM were treated with flexible 3DCRT.5 patients had received cycles of chemotherapy before radiation.New technique of flexible 3DCRT with combination of photon and electron was used in our study,and DT 32.2-64 Gy with conventional split were delivered.CRT technique was mimicked to compare with 3DCRT technique to predict the possibility of lung damage in two methods.ResultsOne patient reached CR and other 7 patients got PR after radiation.Two patients died during the follow-up.The median survival time (MST) was 15.4 months and it was 18.8 months for sequential chemotherapy and radiotherapy group and 9.7 months for radiotherapy alone group.The V20,V30,and ipsilateral and centralateral median lung dosage (MLD) were 20.5%,15.6%,18.8 Gy and 2.2 Gy respectively when the flexible 3DCRT technique was used,whereas they were 36.8%,27.9%,31.1 Gy and 1.2 Gy respectively when the CRT technique was used.They were statistically different for the lung V20,V30 and ipsilateral MLD between the two techniques (P＜0.01),whereas there was no different for the contralateral MLD (P＝0.08).All patients received radiation were found to have lung fibrosis and classified as grades 1-2 radiation pneumonitis.The quality of life was increased from score 2.83 to 3.76 and it was significantly different (P＜0.01).ConclusionMPM is moderately sensitive to radiation.The flexible 3DCRT technique is feasible in the treatment of MPM and lung damage is reduced apparently comparing with the CRT technique.The quality of life of patients with MPM is improved after irradiation.     

三维适形放疗配合腔内后装治疗宫颈癌的 效果

 目的探讨三维适形放疗配合腔内后装治疗宫颈癌的临床疗效及放疗并发症。方法60例宫颈癌随机分 为两组。适形组30例采用6MVX线适形放疗,全盆腔DT40Gy后重新定位,重新作治疗计划继续照射至50Gy,有 局部宫旁残留者缩野推量到60Gy。腔内后装治疗A点总剂量30Gy/5次。常规组30例则采用全盆腔放疗40Gy 后改为盆腔四野照射10Gy,有局部宫旁残留者缩野推量到60Gy。腔内后装治疗A点总剂量（30～36）Gy/（ 5～6）次。两组均作同期化疗。 结果适形组和常规组1、2、3年生存率分别为96.7％、93.3％、90.0％和 86.6%、76.7％、70%(P=0.04、P=0.02和P=0.02), 差异有统计学意义。两组不良反应比较,适形组Ⅰ～Ⅱ 级放射性膀胱炎、直肠炎及盆腔纤维化发生率低于常规组(P=0.007、P=0.006和P=0.003)),其他不良反应 相似。 结论全程三维适形放疗配合腔内后装治疗加同期化疗是治疗宫颈癌的有效肯定的方法,能提高近 期生存率,晚期并发症较常规放疗低。     

立体定向放射治疗胸部肿瘤初步结果

目的：探讨立体定向放射治疗在胸部肿瘤治疗中的应用。方法：自1999年9月--2002年8月，对36例经病理证实的胸部肿瘤进行了立体定向放射治疗。其中原发性肺癌22例，转移性肺癌12例，纵隔肿瘤2例。其中鳞癌16例，腺癌15例，小细胞癌2例，胚胎性癌1例，胸腺瘤1例，软组织肉瘤1例。原发性肿瘤放疗先采用普通外照射50Gy／25次／5周，结束后即行立体定向放射治疗，对于不规则形病灶使用多叶光栅，球形病灶采用圆形限光筒。5-6个共面或非共面野，每次4Gy，每周照射3次，共4-5次。转移性肿瘤单纯立体定向放射治疗，1-4个拉弧照射，每次4Gy，每周3次，共7-10次。立体定向放疗时肿瘤体积为1．85cm^3至104．61cm^3(中位体积24．96cm^3)。结果：治疗结束后2个月拍摄胸部CT片进行疗效评价。可评价疗效的34例中，CR13例，PR14例，NC5例，PD2例。中位随访时间为24个月。一年和二年生存率分别为74.1％和38．4％。毒副反应主要为放射性肺损伤。其中急性放射性肺炎1级17例，2级10例，3级1例，5级2例(该2例肿瘤体积均超过60cm^3且为非共面照射)。晚期放射性肺纤维化1级20例，2级8例。结论：立体定向放射治疗作为普通外照射的补充在胸部肿瘤的治疗中近期疗效较好，远期疗效有待进一步观察。但要注意照射技术，照射体积不宜过大，适当调整非共面照射角度，避免正常肺组织的受照容积过大。     

后程三维适形放疗结合化疗治疗67例中晚期宫颈癌的临床观察

目的:探讨不作腔内后装治疗的中晚期宫颈癌采用后程三维适形放疗结合化疗的疗效。方法:67例宫颈癌随机分为三维适形放疗加化疗组31例（适形组）与常规放疗加化疗组36例（常规组）,适形组患者均不作腔内后装治疗,先采用6MvX 线全盆腔放疗DT40Gy后采用三维适形放疗针对盆腔淋巴区及宫颈原发灶继续照射19Gy,最后再缩野针对宫颈原发灶推量,使宫颈原发灶总量达70～75Gy。常规组则采用全盆腔放疗40Gy后改为盆腔四野照射20Gy,腔内后装治疗A 点剂量30Gy/5 次,使宫颈原发灶A 点达70Gy。两组均作同期化疗,方案为:顺铂30mgd 1～3,5-FU 500mg/m2,d1～5,静脉滴注,第1 周、第5 周各一次。结果:适形组和常规组1、2 年生存率分别为93.5％、90.3％和83.3％、72.2％（P=0.198 和P=0.062）,无显著统计学意义。3 年生存率分别为87.1％和61.1％（P=0.017）,两组有显著的统计学意义。两组毒副作用比较,适形组Ⅰ～Ⅱ级放射性直肠炎及盆腔纤维化发生率低于常规组（P=0.000 和P=0.015）,其他的毒性相似。结论:后程三维适形放疗合并化疗治疗中晚期宫颈癌是一种有效、肯定的治疗方法,能提高患者近期生存率,晚期并发症较常规放疗低。3DCRT在宫颈癌放疗中的作用仍需大宗病例和长期随访来验证其优越性。      

适形放疗加化疗与常规放疗治疗非小细胞肺癌的临床研究

目的采用三维适形放疗(3DCRT)治疗非小细胞肺癌的临床近期疗效,探讨适形放疗结合其它治疗的最佳方式。方法根据非小细胞肺癌肿瘤的大小、分期,用三维适形放疗联合其它治疗对32例病人进行治疗,并设同期对照组32例,用化疗加常规放射治疗,以对比研究。结果32例治疗组病人中CR8例(25%),PR21例(65.6%),NR3例(9.4%),CR PR29例(90.6%),急性放射性食管炎7例(14.2%),急性放射性肺炎4例(12.5%),均为1~2级,治疗后KPS评分提高者31例,1年生存率为86%,中位生存期16.5个月。用化疗加常规放射治疗的32例非小细胞肺癌病人,CR PR21例为65.6%,中位生存期12个月,放射性肺炎及食管炎发生率显著增多。结论在循证医学原则的指导下,三维适形放疗与其它治疗结合,取得较好的临床近期效果,明显改善了病人生存质量,毒副作用轻,病人可耐受。     

三维适形放射治疗和常规放射治疗结肠癌的临床疗效观察

目的分析三维适形放射治疗(3DCRT)和常规放射治疗结肠癌的临床疗效。方法采用3DCRT方法(3DCRT组)辅助治疗117例结肠癌患者,每次5⁶Gy,隔天照射1次,共76Gy,隔天照射1次,共7⁸次,总剂量为408次,总剂量为40⁴2Gy,共照射1342Gy,共照射13¹5d。采用常规放射(CT组)辅助治疗102例结肠癌患者,每次2.0Gy,每周5次,总剂量为6415d。采用常规放射(CT组)辅助治疗102例结肠癌患者,每次2.0Gy,每周5次,总剂量为64⁶8Gy,共照射4468Gy,共照射44⁴8d。比较两组患者的疗效。结果 3DCRT组患者的1、2、3和4年的局部控制率分别为75.3%、66.5%、52.7%和46.1%,CT组患者分别为55.3%、47.2%、36.5%和27.8%,两组差异有统计学意义(P<0.05)。3DCRT组患者的1、2、3和4年的生存率分别为65.2%、55.1%、45.7和40.5%,CT组患者分别为51.2%、42.5%、31.0%和24.6%,两组差异有统计学意义(P<0.05)。3DCRT组患者的血液系统反应和全身反应均较CT组轻,差异有统计学意义(均P<0.05)。结论 3DCRT能明显改善结肠癌的局部控制率和生存率,近期放射反应和远期放射损伤均可耐受。     

三维适形放疗同步化疗治疗Ⅲ期非小细胞肺癌的临床观察

目的:观察三维适形放疗(3DCRT)同期含铂方案化疗治疗不能手术的III期非小细胞肺癌(NSCLC)的疗效、不良反应及生存期。方法:61例III期NSCLC患者31例给予3DCRT同步含铂方案化疗(适形组),30例给予常规放疗(CRT)同步含铂方案化疗(常规组)。两组均采用以铂类为基础的化疗方案先诱导化疗2周期,2周后分别给予3DCRT或CRT。放疗均采用常规分割,总剂量66GY/33F。放疗期间再按期化疗2个周期。结果:两组总有效率分别为87.1%及63.3%,(P<0.05);中位总生存期分别为17个月和14.5月;1、2年局控率分别为77.4%、53.3%和54.8%、29.0%(P<0.05);1年、2年生存率分别70.9%、46.7%(P>0.05)和45.2%、20.0%(P<0.05)。结论:3DCRT同期含铂方案化疗治疗III期NSCLC与常规放疗同步含铂方案化疗相比,能提高有效率和生存率,且放疗相关性不良反应较常规组低。     

局部晚期食管癌三维适形放疗初探

目的:对局部晚期食管癌三维适形放疗方法、疗效及毒副作用进行探讨。方法:50例病例分为3DCRT组(三维适形放疗)和CF组(常规等中心三野放疗),比较其疗效和毒副反应。结果:3DCRT在摆位、剂量分布、正常组织损伤等方面均优于CF组。讨论:3DCRT方法在食管癌放疗中既可增强疗效又减少了毒副作用,是一种食管癌放疗的较好方法。     

复发性宫颈癌30例三维适形放射治疗的疗效观察

目的探讨三维适形放射治疗(3DCRT)复发性宫颈癌的疗效。方法 2002年1月至2007年1月,对30例复发性宫颈癌患者行三维适形放射治疗,每次2～3Gy、每周3～5次,共计15～28次完成,总剂量30～56Gy。结果所有患者均完成3DCRT治疗,有效率(RR)66.6%,其中完全缓解率(CR)23.3%,部分缓解率(PR)43.3%;疼痛缓解率90.9%(20/22),出血完全缓解率91.7%(11/12)。1、2、3年生存率分别为50.0%、26.7%、16.7%。结论三维适形放射治疗复发性宫颈癌疗效较好,可以提高局部控制率和延长生存期,不良反应可以耐受。