利用计算机对肺及纵膈肿瘤照射野的设计探讨

胸部肿瘤以往多采用二野前后对穿照射及前后野加水平野照射,使其脊髓及胸骨受量偏高,纵膈剂量低,高剂量区常位于靶区之外,剂量分布不合理。放射治疗时,要求减少脊髓,正常肺及胸骨的受量(后者尤其对青少年),提高靶区的致死量。作者利用Philips-oss治疗计划系统,选择肺癌及纵膈肿瘤各一例。根据胸部的解剖位置,采用三野成角加楔形板,经治疗计划系统内存参数处理后,绘制出剂量分布曲线,其优点是靶区内剂量分布均匀。在肺癌及纵膈肿瘤达到致死量的同时,脊髓,正常肺组织及胸骨受量减少或为零。     

鼻咽癌放疗致位置性眩晕(附3例报告)

目的：探讨电离辐射对内耳前庭的影响。方法：报道鼻咽癌（ＮＰＣ）放疗致发作性位置性眩晕（ＢＰＰＶ）伴听力减退患者３例。采用耳石微粒复位法（ＰＲＭ）治疗ＢＰＰＶ,针对听力减退给予丹参治疗。结果：３例ＢＰＰＶ,２例痊愈,１例显效,听力下降的４耳语音频率平均提高１０ｄＢ。结论：ＢＰＰＶ可能与辐射所致的前庭损害有关,ＰＲＭ是治疗ＢＰＰＶ是一种有效方法。     

Initial treatment of the early stages (I, II) of supraglottic squamous cell carcinoma: partial laryngectomy versus radiotherapy

The purpose of this study was to define the treatment of choice (partial laryngectomy vs radiotherapy) in the early stage of supraglottic squamous cell cancer (ESSC). One hundred and fifteen patients with ESSC were treated with either partial laryngectomy (25 patients) or with radiotherapy(90 patients) between January 1984 and December 1996. All patients had a follow-up of over ¶29 months. Radiotherapy (RT) had a local control rate of 79%, which increased to 90% with salvage surgery, and a high larynx preservation rate (83%). Partial laryngectomy (PL) offered a better initial local control rate of 84%, which increased to 88% with salvage surgery, and functional results were also good (80%). No statistically significant differences were found between RT and PL. RT was less costly, showed better suitability for treatment, produced moderate morbidity and sequelae, and local recurrence was easier to rescue. However, it is a once-only application technique. PL showed higher immediate postoperative morbidity, higher cost and lower suitability for treatment but had fewer sequelae, offered the best initial local control and is multi-applicable. No clear oncological arguments were found in our series to define whether PL or RT is the treatment of choice for ESSC. Both are effective therapies. Secondary factors such as suitability for treatment, morbidity, cost and applicability should be individually evaluated when choosing the type of treatment. As the laser endoscopic approach decreases morbidity and costs and makes the condition more suitable for treatment, it could be the treatment of choice for ESSC, in cases where local tumoral extent and larynx exposure allow radical excision.     

鼻咽癌咽旁间隙受侵面颈联合野照射疗效观察

目的：评价鼻咽癌咽旁间隙受侵受面颈联合野照射长期疗效。方法：从１９９１年１月至１９９３年１２月,经ＣＴ诊断咽旁间隙侵犯,实行面颈联合野照射的鼻咽癌病人４９例,按临床分期分层随机抽取同时期非面颈联合野射４９例病人为对照组。５年局控率、生存率计算用Ｋａｐｌａｎ－Ｍｅｉｅｒ法,Ｌｏｇ－ｒａｎｋ作显著性检验。计数资料用χ＾２检验。结果：面颈联合野组生存率、局控率曲线图明显高于非面颈联合野组（Ｐ〈０．０５）     

支气管动脉灌注化疗加放疗治疗中晚期肺癌30例疗效观察

目的：通过对原发性肺癌两种方法治疗效果比较,探讨其应用价值。方法：中晚期肺癌７０列,根据不同治疗方法,分为两组。观察组：３０例,做支气管动脉灌注化疗（ＣＢＡＩ）加放疗（ＲＴ）;对照组：４０例,只做ＣＢＡＩ。对两组肿瘤直径缩小率及生存期进行观察对比。结果：ＣＢＡＩ＋ＲＴ组肿瘤缩小率及生存期明显优于ＣＢＡＩ组。结论：根据患者的具体情况,恰当选择和施行ＣＢＡＩ＋ＲＴ有助于提高中晚期肺癌患者的生存期和生存     

微波热疗联合放疗治疗扁桃体癌(附40例临床分析)

探讨微波热疗放疗治疗扁桃体癌的疗效。方法：对２０例扁桃体癌应用放射治疗,２０例应用微波与放射综合治疗,观察并比较其疗效。结果：热疗－放疗综合治疗组临床近期肿瘤消退率９０％,明显高于单纯放疗组,前者肿块消退速度亦明显优于单纯放疗组,且全部病例在治疗期内未发生严重毒副作用。结论微波热疗联合放疗对扁桃体癌的治疗具有协同增敏作用。     

Economic study of neutropenia induced by myelotoxic chemotherapy

This article describes the economic and social impact of nutropenia induced by myelotoxic chemotherapy in patients with cancer during the period 1 January–31 December 1991. Neutropenia is a life-threatening complication of chemotherapy in patients with cancer. The episodes of (ever and infections originating from neutropenia require hospitalization of the patient until the granulocyte levels are restored. The calculation of the economic cost was based on the following parameters: length of stay in hospital, analytical tests performed on the patient, type and cost of drug therapy administered, blood transfusions performed, health assistance received, cost of isolation and absence from work. The overall economic cost of neutropenia in patients with cancer reached 329,775 pesetas ($2,893). Cost of the health-care staff was the largest budget item in relation to the total health resources estimated.     

The impacts of breast conserving treatment and mastectomy on the quality of life in early-stage breast cancer patients

The quality of life (QOL) in 55 early-stage breast cancer patients after surgery was prospectively assessed using a newly developed Japanese QOL questionnaire: The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD). The impacts of breast conserving treatment (BCT) (22 cases) and modified radical mastectomy (MRM) (33 cases) on the QOL in those subjects were compared. The overall QOL scores were evaluated during four periods (before surgery, 0–2, 3–12, and 13–24 months after surgery). The mean scores of the four categories of the QOL-ACD (activity, physical condition, psychological condition, and social relationships) were also compared. The results demonstrated that a significant improvement was observed in the overall QOL scores among the three periods after surgery (0–2, 3–12, and 13–24 months) only in the BCT group (P<0.05). There were no significant differences between the two groups in the overall QOL scores during any of the three periods after surgery, and the mean score of the ‘psychological condition’ during 0–2 months period in the BCT group was significantly lower than that in the MRM group (P< 0.05).     

胰腺转移癌放疗止痛效果近期观察

目的　减轻胰腺转移癌病人的疼痛,提高病人晚期的生活质量。方法　对２８ 例胰腺转移癌癌性疼痛病人在 Ｂ 超和（ 或） Ｃ Ｔ 扫描定位下,采用６０ Ｃｏ 分次外照射,总剂量为３０ ～４０ Ｇｙ 。结果　２８例中、重度癌性疼痛病人的镇痛有效率达９２ ．９ ％ ,显效率为８８ ％ 。结论　６０ Ｃｏ 外照射治疗胰腺转移癌,方法简便,病人痛苦小,止痛效果确切,但存有不能立即止痛,需配合其它止痛药之缺点。     

恶性肿瘤放疗前后血清可溶性白细胞介素2受体含量变化的临床意义

目的　探讨血清可溶性白细胞介素２ 受体（ｓ Ｉ Ｌ２ Ｒ）水平与恶性肿瘤患者的病期及疗效的关系。方法　采用双抗体夹心 Ｅ Ｌ Ｉ Ｓ Ａ 法检测１５９ 例恶性肿瘤患者放疗前后血清ｓ Ｉ Ｌ２ Ｒ 水平。结果　恶性肿瘤患者放疗前血清ｓ Ｉ Ｌ２ Ｒ 水平明显高于正常对照组（ Ｐ＜ ００５）;放疗后血清ｓ Ｉ Ｌ２ Ｒ 水平明显低于放疗前（ Ｐ ＜ ０００１）;晚期患者（Ⅲ＋ Ⅳ期）不论是放疗前或放疗后 ｓ Ｉ Ｌ２ Ｒ 水平均明显高于早期患者（Ⅰ＋ Ⅱ期）（ Ｐ ＜ ００５）;各类恶性肿瘤之间血清ｓ Ｉ Ｌ２ Ｒ 水平无显著性差异（ Ｐ ＞００５）。结论　ｓ Ｉ Ｌ２ Ｒ水平在各种恶性肿瘤中的表达无特异性;检测恶性肿瘤患者ｓ Ｉ Ｌ２ Ｒ 放疗前后水平,是对病情估计和治疗疗效评价的一项参考指标。