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局部晚期食管鳞状细胞癌术后放疗和化疗的前瞻性研究 总被引:5,自引:0,他引:5
Objective To investigate the role of postoperative chemoradiotherapy ( CRT) as a multimodality treatment option for locally advanced thoracic esophageal squamous cell carcinoma (ESCC) by a prospective comparison between surgery alone and postoperative CRT. Methods Using preoperative computed tomography (CT)-based staging criteria, 158 patients with ESCC (stage Ⅱ-Ⅲ) were enrolled in this prospective study. With informed consent, the patients were randomized into two groups: postoperative CRT (78 cases ) and surgery alone (S, 80 cases). After a few minor adjustments to the enrolled patients, the actual patients of postoperative CRT group and S group were 74 cases and 77 cases, respectively. Comparison of the complications, local recurrence rate, distant metastasis rate, survival rate and progression-free survival in the two groups was carried out. Results With a median follow-up of 37.5 months, the 1-,3-,5-, 10-year overall survival (OS) rates were 91.0% , 62.8%,42.3%,24.4% and 87.5% , 51.3% , 33.8% , 12. 5% for the postoperative CRT and S arm, respectively. A significant difference in OS was detected between the two arms (P =0.0276). There was a significant difference of progression-free survival (PFS) between the two arms (P=0.0136). The local recurrence rates in the postoperative CRT group and S group were 14.9% and 36.4% , respectively (P<0.05). No significant difference was detected between the complications of the two groups ( P > 0. 05). Toxicities of chemoradiotherapy in the postoperative CRT arm were moderate, which can be relieved rapidly by adequate therapy. Conclusion Rational application of postoperative chemoradiotherapy can provide a benefit in progression-free survival and overall survival in patients with locally advanced esophageal squamous cell carcinoma. 相似文献
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目的:探讨125I粒子在体内外对人ESCC的疗效和作用机制以及植入治疗胸段中晚期食管鳞癌(ESCC)的安全性及疗效.方法:细胞及动物实验:125I粒子植入体外培养的人食管鳞癌Eca-109细胞,分A组不加粒子(对照组);B组0.2mCi(低剂量组);C组0.4mCi(中剂量组);D组0.8mCi(高剂量组).分析细胞克隆形成率、细胞凋亡指数和细胞周期分布情况;建立裸鼠皮下移植性食管癌模型后,对照组(A组,不做任何处理)、假手术组(B组,穿刺瘤体1次,但不植入粒子)、低剂量组(C组,0.2mCi)、中剂量组(D组,0.4mCi)和高剂量组(E组,0.8mCi),计算各组抑瘤率.临床试验:前瞻性研究,入组时间为2000-2004年.根据ESCC术前CT分期标准,298例Ⅱ-Ⅲ期胸段ESCC患者随机分为术中联合125I粒子植入组及单纯手术组.依据TPS所确定的剂量,A组术中直视下植入125I粒子.选用0.5mCi的125I粒子20-40粒,总活度在10-30mCi,肿瘤匹配周边剂量60-70Gy,术后行粒子验证和质量评估.观察患者术后并发症、监测局部复发情况、评价患者疗效.结果:细胞克隆形成率B、C、D组均低于A组... 相似文献
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局部晚期食管鳞状细胞癌术后放疗和化疗的前瞻性研究 总被引:2,自引:0,他引:2
Objective To investigate the role of postoperative chemoradiotherapy ( CRT) as a multimodality treatment option for locally advanced thoracic esophageal squamous cell carcinoma (ESCC) by a prospective comparison between surgery alone and postoperative CRT. Methods Using preoperative computed tomography (CT)-based staging criteria, 158 patients with ESCC (stage Ⅱ-Ⅲ) were enrolled in this prospective study. With informed consent, the patients were randomized into two groups: postoperative CRT (78 cases ) and surgery alone (S, 80 cases). After a few minor adjustments to the enrolled patients, the actual patients of postoperative CRT group and S group were 74 cases and 77 cases, respectively. Comparison of the complications, local recurrence rate, distant metastasis rate, survival rate and progression-free survival in the two groups was carried out. Results With a median follow-up of 37.5 months, the 1-,3-,5-, 10-year overall survival (OS) rates were 91.0% , 62.8%,42.3%,24.4% and 87.5% , 51.3% , 33.8% , 12. 5% for the postoperative CRT and S arm, respectively. A significant difference in OS was detected between the two arms (P =0.0276). There was a significant difference of progression-free survival (PFS) between the two arms (P=0.0136). The local recurrence rates in the postoperative CRT group and S group were 14.9% and 36.4% , respectively (P<0.05). No significant difference was detected between the complications of the two groups ( P > 0. 05). Toxicities of chemoradiotherapy in the postoperative CRT arm were moderate, which can be relieved rapidly by adequate therapy. Conclusion Rational application of postoperative chemoradiotherapy can provide a benefit in progression-free survival and overall survival in patients with locally advanced esophageal squamous cell carcinoma. 相似文献
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第一次查房主治医师查房,入院3h。
新生儿科住院医师汇报病史。患儿,男,21h,因面色青紫、气促21h入院。患儿出生后即发现其面色青紫、气促,哭闹时加剧,伴轻微咳嗽,吐泡沫样痰,听诊心脏有杂音。剖宫产后当地医院予以常规处理,遂急诊转入我院。患儿无抽搐、嗜睡、昏迷,无排尿哭闹,无皮疹及外耳道流脓等,尚未吃奶,尿量尚可,家族无特殊病史。入院查体:[第一段] 相似文献
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目的 探讨手术切除联合术中125I粒子组织间植入治疗食管癌的疗效和副作用. 方法 回顾性分析2004年10月至2009年9月61例中、晚期食管癌患者(盐城市第五人民医院32例,南京医科大学附属南京第一医院29例)采用手术切除联合术中125I粒子组织间植入或联合放疗治疗的临床资料.根据治疗方法不同,将61例患者分为两组,125I粒子植入组:31例[男21例,女10例;年龄(59.5±1.5)岁],采用手术切除+术中125I粒子组织间植入治疗;对照组:30例[男19例,女11例;年龄(60.1±1.6)岁],术后3~4周采用体外放射治疗.观察两组患者术前、术后白细胞(WBC)、血小板(PLT)、免疫球蛋白的变化,比较生存率、复发率和转移率. 结果 术后1个月、3个月和5个月,两组患者外周血WBC、PLT和免疫球蛋白均在正常范围内;两组间比较差异无统计学意义(P>0.05).两组患者均获随访,随访时间1~5年.术后6个月125I粒子植入组患者行胸部X线片检查示:均未发现粒子移位.125I粒子植入组患者1年、3年和5年生存率均明显高于对照组(3年58.3% vs.42.8%,P<0.05;5年36.8% vs.26.6%,P< 0.05),复发率(3年0%vs.6.7%,P< 0.05;5年3.2% vs.13.3%,P< 0.05)和转移率(3年12.9%vs.20.0%,P<0.05;5年16.1% vs.33.3%,P< 0.05)明显低于对照组. 结论 手术切除结合125Ⅰ粒子组织间植入治疗食管癌,方法简单、使用安全、副作用小,可提高食管癌患者的生存率. 相似文献