中医综合方案维持疗法对晚期非小细胞肺癌患者生存期的影响北大核心CSCD

目的观察中医综合方案维持疗法对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者无进展生存期(progression-free survival,PFS)和总生存期(overall survival,OS)的影响。方法采用前瞻性、随机对照研究方法,将69例晚期NSCLC一线治疗后疾病无进展患者随机分成治疗组(34例)和对照组(35例),对照组采用单药化疗(吉西他滨或培美曲赛多西紫杉醇),治疗组采用中医综合方案维持疗法(中药汤剂、中药静脉制剂及穴位敷贴),21天为1个周期,治疗直至疾病进展或出现不能耐受的毒副反应或患者拒绝继续治疗,治疗结束后定期随访患者生存期。结果两组中位维持治疗周期均为2个周期,差异无统计学意义(P=0.274);治疗组中位PFS为12.43周,对照组为10.00周,差异有统计学意义(P=0.025);治疗组中位生存期(middle survival time,MST)为18.80个月,对照组为16.73个月,两组比较,差异无统计学意义(P=0.437)。结论中医综合方案维持疗法延长患者生存期的疗效与单药化疗维持治疗相当。     

胸腔积液后类圆形阴影与肺癌的鉴别诊断

胸腔积液后类圆形阴影与肺癌的鉴别诊断简红上海市胸科医院（上海２０００３０）本院在近期内收治了多例胸腔积液后，肺内出现圆形病灶的病例，其中有些病例在易感因素、临床症状上均符合肺癌高危人群，临床上高度怀疑肺癌，而最后均被确诊为炎症性的胸腔积液残留胸膜病变...     

氨溴索作为祛痰剂用于阻塞性肺疾病

目的：观察氨溴索在慢性阻塞性肺疾病（ＣＯＬＤ）急性发作期的疗效。方法：４８例随机分为氨溴索组２４例（男性１６例，女性８例；年龄６１±ｓ１３ａ）和对照组２４例（男性１８例，女性６例；年龄５９±１５ａ）。２组常规治疗（头孢拉定、阿米卡星、二羟丙茶碱或氨茶碱、溴己新）相同，前者加服氨溴索３０ｍｇ，ｐｏ，ｔｉｄ×２ｗｋ。结果：治疗１ｗｋ后痰量增加；１ｗｋ和２ｗｋ后咳嗽频率、咳嗽难度和痰液粘稠度减轻，氨溴索组优于对照组（Ｐ＜０．０５）；２ｗｋ后痰量明显减少，但组间无差异（Ｐ＞０．０５）。未发现副作用。结论：氨溴索有良好痰液溶解作用，可作为治疗ＣＯＬＤ的辅助药物。     

短程间歇预防性给予重组人血小板生成素治疗肺癌化疗诱导的严重血小板减少的疗效

Objective To evaluate the efficacy of short-term intermittent prophylactic use of a recombinant human thrombopoietin ( rhTPO) in chemotherapy-induced severe thrombocytopenia in lung cancer patients. Methods 24 advanced non-small cell lung cancer ( NSCLC) patients who experienced severe thrombocytopenia in the last chemotherapy cycle received prophylactic rhTPO treatment in the next chemotherapy cycle (prophylactic treated cycle, PTC). rhTPO was given subcutaneously 300 U ·kg-1· d-1 on days 2, 4, 6, and 9 after the initiation of chemotherapy. Platelet count was monitored and compared with that in the previous treatment cycle (control cycle, CC ). Results The lowerest platelet count in the prophylactic rhTPO cycle was significantly higher than that in control cycle [(56 ± 16)×109/L vs. ( 28 ± 13) × 10'/L, P < 0.001]. The duration of thrombocytopenia was also shortened by the prophylactic rhTPO [(8±2) d vs. (12 ±3) d, P<0.001]. The area under curve (AUC) of platelet count (21 days) was significantly increased [(3517 ± 685 ) x 109/L vs. (2063 ± 436)×109/L, P < 0. 001]. The time to platelet nadir and peak was not affected. Conclusion Prophylactic use of rhTPO can attenuate the severity and shorten the duration of chemotherapy-induced thrombocytopenia in lung cancer patients.