Treatment options for primary splenic low‐grade non‐Hodgkin's lymphomas

The purpose of this comparative study was to evaluate the response of primary splenic low‐grade non‐Hodgkin's lymphomas (NHL) to chemotherapy, splenectomy, and chemotherapy combined with splenectomy in order to elaborate the optimum treatment modality. A total of 104 patients (age range: 15–82 years) with primary low‐grade B‐cell NHL of the spleen were comprised by our study. Stage IV disease was determined in 102 (98.1%) cases. Regarding the treatment modality, splenectomy was performed in 14 patients, early splenectomy and single‐agent chemotherapy in 15, early splenectomy and combined chemotherapy in 19, single‐agent chemotherapy in 23, and combined chemotherapy in 33. In the above‐mentioned order, complete remission rate was following: none, 40.0, 31.6, 21.8, and 18.2%. Partial remissions were achieved in 85.7, 46.7, 57.9, 30.4, and 69.7% of cases, respectively. The median remission duration turned out to be longer (74.5 months) in the group of patients with complete remissions attained by means of splenectomy and combined chemotherapy. Local relapses in the spleen developed in 19 (72.7%) patients treated with combined chemotherapy and in 9 (90.0%), who had undergone single‐agent chemotherapy. The 5‐year overall survival was 54.4% after splenectomy, 39.4% after single‐agent chemotherapy, and 37.1% after combined chemotherapy, being significantly higher (P < 0.05) after splenectomy and single‐agent chemotherapy (67.2%), and splenectomy followed by combined chemotherapy (64.7%). Early splenectomy combined with chemotherapy is the optimum treatment option for primary low‐grade NHL of the spleen because of the superiority in complete remission rate, remission duration, and in overall survival rate. Splenectomy leads to somatic compensation of patients, makes impossible local relapsing in the spleen, prevents continuous dissemination from the primary tumor site, and mostly corrects cytopenias, creating better conditions for chemotherapy.     

Use of an Implantable Catheter System for Intraperitoneal Chemotherapy in Ovarian Cancer

Abstract: To check the efficiency of intraperitoneal chemotherapy of ovarian carcinomas, 15 patients were treated with instillations of mitoxantrone or cisplatinum. An implantable catheter system was used to access the abdominal cavity. Local therapy proved to be without any effect when large tumor masses were treated. Patients with small tumor residues after surgery did not benefit either, partly because of extraperitoneal progress of the disease. Patients without evidence of disease proved to be stable. Side effects of the therapy were usually mild compared with those of systemic chemotherapy. Access to the peritoneal cavity with the implantable catheter proved to be safe and reliable.     

The effect of adjuvant therapy with or without tamoxifen on the endocrine function of patients with breast cancer

The ovarian and pituitary functions of 64 operable breast cancer patients undergoing adjuvant therapy with cytotoxic chemotherapy and/or tamoxifen were investigated. The post menopausal patients, divided into 3 treatment groups, one with tamoxifen alone, one with tamoxifen and chemotherapy and the other with chemotherapy alone had serum estradiol 17-β (E2) and progesterone levels lower than the evaluable limits. Although there was no significant difference in the level of estrone sulfate (E1-S) between these three groups, the level of lutainizing hormone (LH) and follicle stimulating hormone (FSH) in the patients treated with tamoxifen alone and tamoxifen and chemotherapy were significantly lower than those treated with chemotherapy alone. The decrease in gonadotropin levels induced by tamoxifen treatment was reversible as it appeared after the initiation of tamoxifen and recovered after its cessation. In the premenopausal patients, a group treated with tamoxifen and chemotherapy had significantly higher E1-S, E2 and progesterone levels and significantly lower gonadotropin levels than a group treated with chemotherapy alone or one treated with a cyclophosphamide regimen. These increases in the levels of estrogen and progesterone were also reversible, and induced by tamoxifen. Thus, adjuvant endocrinochemotherapy causes profound alteration in the hypothalamo-pituitary-ovarian axis and therefore, monitoring a variety of hormonal levels is thought to be necessary for assessing the consequences of adjuvant therapy in breast cancer patients, especially in premenopausal patients using tamoxifen.     

化疗对淋巴瘤伴乙肝病毒感染患者肝功能影响的回顾性分析

目的研究化疗对淋巴瘤伴乙肝病毒感染患者肝功能的影响。方法回顾性病例分析，比较50例HBsAg（-）、20例HBsAg（＋）和18例小三阳的恶性淋巴瘤患者化疗后肝功能变化情况。结果HBsAg（-）组、HBsAg（＋）组和小三阳组化疗后Ⅲ级以上肝功能损害分别是0％、15％、55％。结论伴乙肝病毒感染的淋巴瘤患者化疗后肝功能损害明显，尤其小三阳患者损害更为严重，甚至死亡。     

顺铂联合足叶乙甙治疗原发灶未明转移癌的临床观察

目的　观察顺铂 (DDP)联合足叶乙甙 (VP -16 )治疗原发灶未明转移癌 (MUO)的疗效。方法　 10例MUO患者均采用EP方案 :DDP 30mg m2 第 1～ 3天 ,足叶乙甙 (VP -16 ) 6 0mg m2 第 1～ 5天 ,2 8天为一周期。结果　 10例中 4例达到完全缓解(CR)为 40 %,3例部分缓解 (PR)为 30 %,2例稳定 (SD)为 2 0 %,1例进展 (PD)为 10 %。结论　顺铂联合足叶乙甙对原发灶未明转移癌有较好的疗效 ,且毒副反应可以耐受。     

骨转移癌的止痛治疗研究

目的：研讨放疗联合化疗（小剂量顺铂）对转移性骨癌的止痛效果。方法：将符合条件的转移性骨癌患者分成放疗联合顺铂组、单纯放疗组，观察止痛疗效。结果：放疗联合顺铂组与单纯放疗组，1、2级疼痛止痛疗效相似（P〉0．05）。3级疼痛完全缓解率放疗联合顺铂组优于单纯放疗组（P〈0．05）。结论：放疗联合顺铂治疗转移性骨癌，对重度骨痛者疗效明显，可提高完全缓解率，不明显增加毒副作用，该方法值得临床应用。     

Ivermectin for the chemotherapy of bancroftian filariasis: a meta-analysis of the effect of single treatment

Summary The efficacy and safety of ivermectin in the treatment of filariasis due to Wuchereria bancrofti was assessed by a meta-analysis of the results from 15 published clinical trials. Seven hundred and forty-eight microfilaraemic patients were enrolled in 7 dose-finding and 8 comparative studies. Administered as a single dose, ivermectin induced nearly complete clearance of microfilariae from the blood from the first day to 30 days post-treatment, followed by gradual recurrence of microfilaraemia and increase in its intensity. Higher doses of ivermectin showed greater clearance effects and maintained lower microfilaraemia levels for a longer time. The adverse reactions caused by the drug were flu-like, transient, generally mild and well tolerated by patients. The frequency and intensity of adverse reactions were strongly associated with pretreatment microfilaria counts in the blood, but independent of dose. The findings of the meta-analysis suggest that ivermectin given at a single annual dose of 200 μg/kg body weight or higher, whether or not in combination with DEC, has great potential for therapeutic strategies to control bancroftian filariasis.     

猪尾导管连接化疗药盒实现肝脏肿瘤多重化疗的可行性研究

目的 探讨使用猪尾造影导管与单一化疗药盒连接实现肝脏肿瘤多重化疗的可行性及初步疗效。资料与方法 对30例晚期肝脏恶性肿瘤患者采用经股动脉穿刺、腹腔动脉内植入猪尾导管与皮下埋置药盒并序贯化疗，统计手术成功率、并发症及临床疗效。结果 30例手术全部成功，发生切口延迟愈合1例。术后随访28例，经影像学复查对比，病变缩小7例，稳定12例，进展9例。随访期间12例患者死亡，术后生存期42d-10个月，中位生存期6个月。另外16例患者至今存活，已达术后2-16个月。结论 采用猪尾造影导管置于腹腔动脉并与化疗药盒相连接，能够对晚期肝脏恶性肿瘤实现多重化疗，技术上简单可行，并发症少，初步疗效令人满意。     

Treatment strategies for hepatic metastasis from colorectal cancer

Hepatic micrometastases of the parenchyma adjacent to a macroscopic lesion were detected in 17 of 31 resected liver metastases. Fifty-nine micrometastatic lesions were detected in total; 26 lesions were situated in the portal vein (PV), 22 in the central vein (CV), 5 in the bile duct (BD), and 6 in the sinusoid (SS). A histological study confirmed the direct invasion of the macrometastatic cancer cells into the adjacent PV, CV, BD, and SS. According to the tumor doubling time, the mean diameter of the macrometastases in 19 remnant livers was calculated to have been 0.57±0.87 cm at the time of the primary resection. The calculated diameter of 3 of these 19 macrometastases was found to be less than 0.01 cm, the minimum implantable size, indicating that the cancer recurrence in these specimens may have developed from macroscopic metastatic lesions as a satellite, and not from the primary tumor. In 13 patients who received doses of 5250 mg or more of 5 fluorouracil (FU) via the hepatic artery, the cumulative disease-free rate 2 years postoperatively was 100%; this value was 47.6% in 11 patients who received less than 5250 mg of 5 FU via the hepatic artery, and 0% in 39 patients who received no chemotherapy (P<0.005). These results suggest that anatomical hepatic resection for satellite lesions, combined with prophylactic hepatic arterial chemotherapy for micrometastases, decreases the recurrence rate of hepatic metastases in the remnant liver.     

肺癌放疗或化疗后的病理形态及PCNA,p53表达的观察

应用抗增殖细胞核抗原和抑癌基因ｐ５３蛋白的单克隆抗体对３７例放疗或化疗后的肺癌进行了检测，并与未经术前治疗的肺癌组织进行对照，部分组织进行了超微结构观察。结果发现：（１）放疗或化疗对肺癌组织细胞浆及胞核有不同程度的破坏。（２）放、化疗后组织（除分化型腺癌外）ＰＣＮＡ指数下降明显（Ｐ＜０．０１或Ｐ＜０．０５）。（３）放疗后肺癌组织ｐ５３表达率减低，但化疗后变化不明显。