Difficulties using the Franco-Italian Glossary in assessing toxicity of cervical cancer treatment

Shakespeare TP, Ferrier AJ, Holecek MJ, Jagavkar RS, Stevens MJ. Difficulties using the Franco-Italian Glossary in assessing toxicity of cervical cancer treatment. Int J Gynecol Cancer 1998; 8: 51–55
We assessed the toxicities of patients treated for cervical cancer using the revised Franco-Italian Glossary (FIG). A total of 69 separate complications were appraised in 47 patients; however, only 43.5% of these side-effects could be accurately graded. In all, 56.5% of toxicities could not be scored for a variety of reasons: (1) the FIG does not account for all possible complications of cervical cancer treatment; (2) some important toxicities are regarded as too minor to be graded; (3) subjective assessment of some side-effects did not allow consensus to be reached when assigning a grade; (4) we could not accurately score toxicities using the FIG in a retrospective manner. Previous studies utilizing the FIG retrospectively have noted few problems with its use, with no indication of the number of toxicities unable to be graded. In view of the inability to grade the majority of complications in the present study in an accurate manner, we conclude that the revised FIG requires detailed data that are best collected prospectively and that several minor modifications of the glossary should be considered. Results of studies using the glossary retrospectively should be viewed with caution.     

食管癌加速超分割放疗的临床研究

目的：评价加速超分割放射治疗食管癌的疗效。方法：食管鳞癌９８例随机分为常规组和加速超分割组。常规组：１８０～２００ｃＧｙ／次，５次／周，总量６０００～７０００ｃＧｙ／６～７周；加速超分割组：１５０ｃＧｙ／次，２次／日，间隔６小时，总量５４００ｃＧｙ／３５周。两组病人均采用６０Ｃｏ远距离外照射。结果：常规组１，３，５年生存率分别为４６％（２３／５０）、２０％（１０／５０）、１２％（６／５０）；加速超分割组１，３，５年生存率分别为７０８％（３４／４８）、３９６％（１９／４８）、２９２％（１４／４８），加速超分割组明显优于常规组（Ｐ＜００５），而两组放疗反应和并发症无明显差异。结论：加速超分割放疗能明显提高食管癌病人的生存率，但不增加放疗反应及并发症。     

双介入并中药治疗胰腺癌35例

对３５例胰癌病人在超声引导下，局部注射纯乙醇顺铂溶液，由肿瘤远端边退针边注射，一般７－１０天注射１次，直至活栓组织中癌细胞转阴为止。并给予“胰宝康泰”辅治疗，该药具有免疫增强作用。本组３５例的半年、１年、２年活率分别为８５．７％、６８．８％、５１．４％，中位生丰了期为１０．３个月，疗效满意。     

硒对二乙基亚硝胺诱发大鼠肝癌生长的抑制作用的观察

观察硒对二乙基亚硝胺诱发大鼠肝癌的影响。方法；在诱癌过程中，大鼠分别投予含０．２，１．０，３．０×１０＾－６硒的饲料，检测血，肝组织ＬＰＯ，ＧＳＨ－ＰＸ活性，观察诱癌率及癌结节面积。结果：补Ｓｅ后对诱癌率无显著影响，但补充３．０×１－０＾－６Ｓｅ可使癌结节面积显著减少。补Ｓｅ可显著地减轻诱癌早期血和肝组织中ＬＰＯ的形成及诱癌过程中血和肝组织中ＧＳＨ－ＰＸ活性的降低。     

Copper radionuclides and radiopharmaceuticals in nuclear medicine

The chemistry, radiochemistry, radiobiology, and radiopharmacology of radiopharmaceuticals containing copper radionuclides are reviewed. Copper radionuclides offer application in positron emission tomography, targeted radiotherapy, and single photon imaging. The chemistry of copper is relatively simple and well-suited to radiopharmaceutical application. Current radiopharmaceuticals include biomolecules labelled via bifunctional chelators primarily based on cyclic polyaminocarboxylates and polyamines, and pyruvaldehyde-bis(N⁴-methylthiosemicarbazone) (PTSM) and its analogues. The chemistry of copper, of which only a fraction has yet been exploited, is likely to be applied more fully in the future.     

115例腹会阴直肠切除术会阴伤口一期缝合的评估

本文就115例腹会阴直肠切除术,对会阴伤口的两种不同处理方法进行分析比较.在年龄、性别、病理分期及恶性程度无明显差异的情况下,会阴伤口一期缝合组的平均愈合时间为16.90±4.35天,伤口敞开组为37.04±15.44天,差异显著(P<0.002).术后局部复发率分别为3/69例和2/46例,均为4.35%(P>0.05).一期缝合组的平均住院费用约为敞开组的46.87%～76.52%.作者指出,鉴于直肠癌逆行向下的淋巴扩散极为罕见,仅发生于高恶性或伴广泛淋巴转移的病例,因而对癌肿远端需切除2cm～3cm正常肠管而同时切除肛直肠环、不得不作手术者,会阴部清除范围无需太大,会阴伤口可分层完全缝合;对位于肛管内或侵及肛直肠环的癌肿,须彻底清除坐骨直肠窝脂肪结缔组织.本文两组术后局部复发率无差异,进一步表明这一认识的正确性.本组结果充分表明了会阴伤口一期缝合法的合理性与可行性.     

地塞米松对肺癌切除术病人血清过氧化脂质胰岛素皮质醇的影响

４０例肺癌切除术病人，随机分为对照（Ｓ）组和地塞米松（Ｓ－Ｄ）组，采用氯胺酮－安氟醚静吸复合麻醉，对血清中过氧化脂质、胰岛素和皮质醇进行了初步观察。结果表明，血清过氧化脂质Ｓ－Ｄ组于手术毕显著低于Ｓ组（Ｐ〈０．０５）；血清胰岛素两组间没有统计学差异；血清皮质醇Ｓ－Ｄ组于气管插管后显著高于Ｓ组（Ｐ〈０．０５）。作者认为肺癌切除术病人术前给地塞米松可有效地降低血清中过氧化脂质含量，利于维护脏器功能。     

Prolonged suppression of spermatogenesis by oestrogen does not preserve the seminiferous epithelium in procarbazine-treated rats

We examined the hypothesis that induction of reversible testicular atrophy, subsequent to withdrawal of gonadotrophin support, would alleviate the testicular toxicity of the anti-cancer drug procarbazine. In rats, severe but reversible testicular atrophy and suppression of spermatogenesis were induced 56 days after the subcutaneous insertion of a silastic implant containing oestradiol-17 beta. The effect of this treatment upon the testicular toxicity of four weekly doses of procarbazine (200 mg kg-1) was examined 56 days after the termination of procarbazine/oestrogen treatment. At this time the testicular endocrine and spermatogenic functions were close to normal in rats which has received only oestradiol-17 beta. Procarbazine produced severe testicular atrophy which was associated with azoospermia and destruction of the germinal epithelium. Serum LH and FSH concentrations were raised and were associated with low serum concentrations of both testosterone and androgen-binding protein. The combination of procarbazine with the oestrogen treatment did not change any of the testicular toxicity and in some cases it appeared to be exacerbated. In contrast to these experiments other studies have indicated that the testis can be protected if spermatogenesis is reversibly suppressed by other agents which are also active via the pituitary endocrine system. The data would therefore suggest that protection is achieved either by some testicular change other than withdrawal of pituitary gonadotrophin support or that oestradiol-17 beta has additional activity which is permissive for the development of the testicular toxicity of procarbazine.     

恶性梗阻性黄疸的外科姑息治疗

不能切除肿瘤的恶性梗阻性黄疸的外科姑息治疗方法繁多，本文介绍自1989年以来，采取开腹经不同途径的带支撑导管胆肠内引流的方法治疗30例，减黄确切，尚对7例高位胆管癌在解除胆道梗阻的基础上行术后(192)Ir和(60)Co联合放疗，提高了病人生存质量及延长了生命。