排序方式: 共有57条查询结果,搜索用时 15 毫秒
1.
为探索重度梗阻的局部晚期食管癌理想的治疗方法 ,笔者自 1 996年 1 0月至 2 0 0 0年 1 0月 ,对 38例严重进食梗阻而无远地转移的局部晚期食管癌患者 ,经插鼻饲管、支持营养等治疗后给予根治性放射治疗 ,取得较好的疗效 ,现将结果报道如下。一、材料与方法1 .临床资料 :38例中 ,男 2 5例 ,女 1 3例 ;年龄 39~ 71岁 ,中位年龄 58岁。病理证实全部为鳞癌。病变位于胸上段者5例 ,中段 31例 ,下段 2例。病变长度 <5cm 5例 ,5~ 8cm2 3例 ,>8cm 1 0例。出现梗阻时间为 1~ 1 5个月 ,中位时间3个月。滴水不进 33例 ,时间 1~ 8d ,平均 2 .… 相似文献
2.
自杀基因联合放射对食管癌细胞株的实验研究 总被引:3,自引:0,他引:3
目的自杀基因具有能将无细胞毒性的前体药物转化为有细胞毒性作用的药物而使细胞死亡,通过观察大肠杆菌胞嘧啶脱氨酶/氟胞嘧啶(CD/5-FC)自杀基因系统对食管癌EC109细胞杀伤效应及与放射联合应用对食管癌肿瘤细胞协同杀伤效应。方法采用PCR方法从大肠杆菌基因组DNA中扩增出CD基因;构建重组真核载体pcDNA3.1-CD;用脂质体转染法转染EC109细胞;观察CD/5-FC体系对EC109细胞的杀伤效应和旁观者效应及对放射的增敏效应。结果RT-PCR分析结果表明CD基因已转入EC109细胞并表达。离体实验证实5-FC对转CD基因后的食管癌细胞株有明显的细胞毒作用,含5%的转基因食管癌细胞加入5-FC后的细胞存活比率为41.8%±14.2%,低于对照组的94.6%±4.3%结果(t=3.14,P<0.05);加入10%的转基因细胞的存活比率为37.8%±4.4%,低于对照组的95.6%±5.4%结果(t=9.75,P<0.01)。CD/5-FC体系对肿瘤细胞放射增敏效果明显,加前药5-FC及放射组细胞存活曲线低于单纯加前药5-FC对照组或单纯放射对照组,重复测量数据方差分析结果显示F=11.50,P<0.01;治疗组分别与5-FC对照组及单纯放射对照组相比F值分别为4.11、10.53,P值分别<0.05、0.01。结论CD/5-FC体系的旁观者效应和放射增敏效果明显。 相似文献
3.
4.
袁婕 《福建医科大学学报》2015,(1):62-66
脑转移癌是一种常见的肿瘤神经系统并发症,约20%~40%的颅外恶性肿瘤在病程中发生脑转移[1]。常见的原发肿瘤为肺癌、乳腺癌、恶性黑色素瘤、肾癌等,其中肺癌脑转移率高达50%,以非小细胞肺癌(non-small cell lung cancer,NSCLC)最常见[2]。随着MRI等诊断技术的提高,脑转移患者的检出率也呈现上升趋势。肺癌脑转移患者预后较 相似文献
5.
目的 探讨后程加速超分割放射治疗非小细胞肺癌的临床价值.方法 81例非小细胞肺癌患者进入本研究,随机分为后程加速超分割放疗组(LCAH组)、常规放疗组(CRT组).LCAH组常规放射治疗40Gy后,改用后程加速超分割推量治疗,1.5Gy/次,2次/天,5天/周,总剂量至70Gy.CRT组常规放射治疗68~72Gy.结果 所有患者均完成全部疗程.CRT组CR 5.1%,PR53.8%,总有效率(CR PR)为58.9%;LCAH组CR 11.9%,PR 69%,总有效率(CR PR)为78.6%.两组比较差异无统计学意义(P>0.05);毒性反应Ⅲ级放射性食管炎:LCAH组4例,CRT组1例;Ⅲ级肺损伤:LCAH组2例,CRT组1例;1,3年生存率分别为53.8%(21/39),12.8%(5/39)和76.2%(32/42),19.1%(8/42).1年生存率两组间差异有统计学意义(P<0.05),3年生存率两组差异无统计学意义(P>0.05).结论 后程加速超分割放射治疗非小细胞肺癌有较好的近期疗效,绝大多数患者可以耐受该方法的急性毒性反应.远期疗效和晚期并发症有待进一步随访观察. 相似文献
6.
食管癌常规放疗与三维适形放疗剂量分布的比较 总被引:1,自引:0,他引:1
目的比较食管癌常规三野照射和三维适形放射治疗2种不同的治疗方法,不同设野方法的计划中靶区及正常组织的受量。方法应用三维治疗计划系统(TPS)在28例食管癌患者的CT虚拟图像上分别设计2种外照射计划(A:常规三野;B:三维适形三野),应用剂量体积直方图比较2种计划肺、心脏等正常组织受量及肺正常组织并发症发生概率(NTCP)的区别。根据肺的NTCP来估计放射性肺炎的发生概率。结果常规三野照射和适形放射治疗的比较:PTV各项指标无显著性差异,心脏受照的体积百分比(V40、V50)及左右肺及双肺受照的体积百分比(V20、V30)等有明显的差异(P=0)。结论食管癌三野常规照射与适形放射治疗比较:三野的适形放射治疗有利于保护心脏及正常肺组织,可降低放射性肺炎的发生概率。 相似文献
7.
目的 探讨根据预后因素给予非小细胞肺癌(NSCLC)脑转移者不同放射剂量的疗效及耐受性。 方法 111例未经脑部治疗和全身化疗的NSCLC脑转移患者分3组:(1)A组2 0例(肺癌术后,脑内单一转移病灶) ,全脑照射14d肿瘤量30Gy ,缩野至残留病灶外1cm ,照射5d肿瘤量15Gy ,总剂量至4 5Gy ;(2 )B组34例(肺癌术后,脑多发转移病灶) ,全脑照射17d肿瘤量39Gy ;(3)C组5 7例(脑内多发病灶及肺部有病灶) ,全脑照射14d肿瘤量30Gy。 结果 (1)近期疗效:3组放射治疗后颅内压增高症状均得到缓解;神经压迫症状缓解率分别为8/ 8(10 0 % )、15 / 17(88.2 % )和2 8/ 35 (80 % )。(2 )远期疗效:总中位局部控制时间10个月(4~4 5个月) ,1和2年控制率分别为6 3.2 %、13.7%。总中位生存期为9.3个月(4~4 5个月) ,1和2年生存率分别为6 2 .7%、12 .8%。(3)Cox多因素分析提示放射剂量提高可提高脑病灶的局部控制时间(P =0 .0 5 ) ,多因素分析显示卡氏评分对患者的生存期有影响趋势(P <0 .0 1)。 结论 根据预后因素给予NSCLC脑转移不同的放射剂量可得到较好的局部控制时间,避免对部分病人过度治疗。 相似文献
8.
Objective To compare accuracy of methods to measure lesion of thoracic segment esophageal carcinoma, and to provide the theory evidence for the precise sketch of irradiation targets.Methods A total of 598 patients with thoracic segment esophageal squamous cell carcinoma were enrolled in this retrospective study.Their lesion lengths were measured and compared respectively in intraoperative specimen,X-ray barium meal and CT.Results Measured mean lengths of lesion were respectively(6.70±2.52)cm,(5.13±1.91)cm and(5.23±1.93)cm in CT,X-ray barium meal and intraoperative specimen.There were significant differences in lesion lengths between intraoperative specimen and CT (P=0.000).There were no significant differences in lesion lengths between intraoperative specimen and X-ray barium meal(P=0.106).Lesion lengths were from top to bottom CT,intraoperative specimen and X-ray barium meal.There were no significant differences in lesion lengths between different pathological type,different T staging intraoperative specimen and X-ray barium meal(P>0.05),but there were significant differences in lesion lengths between different pathological types(except intracavitary type),different T stagings intraoperative specimen and CT(P<0.05). Conclusion Lesion length measured with CT is longer than that measured with intraoperative specimen,but it is shorter with X-ray barium meal than that with intraoperative specimen.It is suggested that X-ray barium meal and other examinations should be referred generally in using CT to depict esophageal carcinoma radiotherapy area. 相似文献
9.
目的观察热疗配合同步放化疗配合治疗中晚期巨块型宫颈癌的近期疗效,同时评价影像学在放射治疗中随访的作用。方法 73例病理确诊Ⅱb~Ⅲb巨块型中晚期宫颈癌患者进行回顾性分析。试验组(热放化疗组)43例,对照组(放化疗组)30例。外照射采用6~18MVX射线前后野对穿或四野合式照射。DT 45~50Gy后。盆腔淋巴结转移DT56~60Gy。Ir-192 HDR腔内后装放疗,总处方剂量28~35Gy。每周1次,共5~6次。放疗开始同时配合3~4周TP方案的化疗。热疗每周2次,共6~8次在3~4周内完成。结果热放化疗组完全缓解(CR)30例(69.8%),部分缓解(PR)10例(20.9%)。治疗总有效率90.7%(CR为70%,PR为20.9%),放化疗组总有效率80.0%,完全缓解(CR)17例(56.7%),部分缓解(PR)7例(23.3%)。鳞状细胞相关抗原(SCC)明显下降63例。治疗结束及治疗后3个月复查B超、MRI或CT复查提示肿瘤明显缩小,完全退缩率100%。其中4例SCC升高影像检查提示肿瘤远处转移。急性毒性反应:Ⅲ度的骨髓抑制和急性胃肠道反应5例(12%)。结论中晚期巨块型宫颈癌放化疗及热疗联合应用,患者耐受性好,是一种有效可行的综合治疗方法。同时能提高晚期宫颈癌局部消退率。 相似文献
10.
淋巴结阳性胸段食管鳞癌术后放化疗临床研究 总被引:1,自引:0,他引:1
目的 对淋巴结阳性胸段食管鳞癌术后放化疗与术后放疗进行回顾性分析,观察其疗效和不良反应.方法 选择首程治疗行胸段食管鳞癌三野淋巴结清扫根治术,术后病理有淋巴结转移、无远处转移患者304例,其中术后放疗组140例,术后放化疗组164例.术后放疗剂量50 Gy,化疗方案为顺铂加紫杉醇,21 d为1个周期,平均2.35个周期/例.结果 术后放化疗组和术后放疗组3年总生存率、无瘤生存率分别为65.7%和52.8%(χ2=6.90,P=0.009)、62.5%和52.8%(χ2=4.75,P=0.029);锁骨上区淋巴结转移率、远处转移率、总复发转移率分别为1.8%和7.1%(χ2=5.21,P=0.022)、18.3%和27.9%(χ2=3.94,P=0.047)、27.4%和39.3%(χ2=4.80,P=0.028);早期不良反应的中性粒细胞减少、放射性食管炎、胃肠道反应分别为96.3%和32.1%(χ2=140.31,P=0.000)、37.2%和26.4%(χ2=4.01,P=0.045)、23.2%和5.0%(χ2=19.77,P=0.000);晚期不良反应分别为6.1%和5.0%(χ2=0.17,P=0.678).结论 淋巴结阳性胸段食管鳞癌术后放化疗能提高生存率和无瘤生存率,降低锁骨上区淋巴结转移率、远处转移率和总复发转移率,早期不良反应重于单纯术后放疗,但患者能耐受治疗.Abstract: Objective To retrospectively analyze the treatment results and side effects of postoperative chemoradiotherapy and postoperative radiotherapy of thoracic esophageal squamous cell carcinoma (EPC) with positive lymph nodes.Methods Three hundred and four patients of thoracic EPC were initially treated with three-field lymphadenectomy, with pathological positive lymph nodes and without distant metastases;and randomly divided into two groups:140 patients of the simple postoperative radiotherapy (RT) and 164 patients of postoperative chemoradiotherapy (CRT).The median total dose was 50 Gy.The regimen of concurrent chemotherapy included cisplatin and taxol, and the intermission was 21 days;the median cycles were 2.35.Results The 3-year overall survival rates were 65.7% of CRT and 52.8% of RT (χ2=6.90,P=0.009), and The 3-year disease-free survival rates were 62.5% of CRT and 52.8% of RT (χ2=4.75,P=0.029).The incidences of the supraclavicular lymph-node metastases were 1.8% and 7.1%(χ2=5.21,P=0.022), respectively;and the incidences of distant metastases were 18.3% and 27.9%(χ2=3.94,P=0.047), respectively;and the incidences of overall metastases and recurrences were 27.4% and 39.3%(χ2=4.80,P=0.028), respectively.Early side effects included granulopenia (96.3% and 32.1%,χ2=140.31,P=0.000), radiation-induced esophagitis (37.2% and 26.4%,χ2=4.01,P=0.045),and gastrointestinal toxicity (23.2% and 5.0%,χ2=19.77,P=0.000).Late side effects were 6.1% and 5.0%(χ2=0.17,P=0.678), respectively.Conclusions Postoperative chemoradiotherapy of thoracic EPC with positive lymph nodes can improve the overall survival and disease-free survival, decrease the incidence of the supraclavicular metastases, the distant metastases, the total metastases and recurrences.More severe early side effects were observed in chemoradiotherapy than in the radiotherapy group,but well tolerated. 相似文献