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@#<b>Objective</b> To investigate the changes of chromosome aberration and micronucleus frequencies in the peripheral blood of patients with cancer before and after treatment, and to provide a basis for clinical prevention and treatment. <b>Methods</b> We collected the physical examination data of 102 patients with cancer before and after treatment from 2016 to 2021 to analyze the changes of chromosome aberration and micronucleus frequencies in peripheral blood. <b>Results</b> Before and after treatment, there were significant differences in chromosome aberration frequency and micronucleus frequency in peripheral blood lymphocytes in patients having radiotherapy or chemoradiotherapy (all <i>P</i> < 0.05), but no significant difference was observed in either index for patients having chemotherapy (both <i>P</i> > 0.05). Before and after radiotherapy, there were significant differences in the numbers of patients with abnormal chromosome aberration frequency and those with abnormal micronucleus frequency in lymphocytes (both <i>P</i> < 0.001). Before and after chemotherapy, there was no significant difference in the number of patients with abnormal chromosome aberration frequency (<i>P</i> = 0.100) or those with abnormal micronucleus frequency (<i>P</i> = 0.110). <b>Conclusion</b> Radiotherapy can cause abnormalities in chromosome aberration and micronucleus frequencies in peripheral blood lymphocytes, which can be useful for monitoring radiotherapy injury to formulate effective emergency plans and evaluate radiation dose in each course of treatment.
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Breast cancer is a malignant tumor with a variety of complex mechanisms. Current researchers generally believe that its cause may be related to living environment， daily mood， heredity， behavior habits， et al， but its specific pathogenesis has not yet been studied clearly. With the rapid increase in the number of breast cancer patients worldwide， the clinical treatment methods in most countries have also been continuously improved. At present， the methods such as surgery， radiotherapy and chemotherapy， immunotherapy， and endocrine therapy are mainly adopted in clinical practice. These methods have increased the survival rate of patients， but still with the possibility of recurrence and metastasis， and there are obvious sequelae. Some postoperative patients also experience psychological pressure and burden， which would greatly affect the quality of life. A large number of experiments and clinical experience have proved that due to its unique advantages， traditional Chinese medicine（TCM） has serially improved its current status in the extensive treatment of breast cancer. No matter in post-operative rehabilitation or in the process of co-radiation and chemotherapy， it has played an increasingly prominent role. TCM can improve human immunity， regulate the body's environment， effectively prevent the recurrence and metastasis of breast cancer， improve postoperative recovery， reduce the complications of radiation treatment and iatrochemistry， expressively improve the quality of life of patients， and prolong the survival time of patients. In recent years， the effectiveness of TCM in the treatment of breast cancer has brought more and more great trust from the patients in TCM， and most patients are willing to actively receive TCM treatment， so the mechanisms and approaches of TCM intervention in the treatment of breast cancer still need further research and exploration by our medical workers. By consulting the latest domestic and foreign literature， we reviewed the research progress on five approaches of TCM intervention in the treatment of breast cancer， including signaling pathways， immunotherapy， endocrine therapy， chemotherapy， and radiotherapy. Signal pathway intervention was explained mainly based on wingless-type MMTV integration site family members（Wnt）signaling pathway ， B-cell lymphoma-2 （Bcl-2）-associated X protein（Bax）/Bcl-2/cysteinyl aspartate specific proteinase-3（Caspase-3）signaling pathway， phosphatidylinositol 3-kinase（PI3K）/protein kinase B（PKB/Akt）/mammalian target of rapamycin（mTOR）signaling pathway， a highly conserved signal transduction pathway to regulate cell-cell communication（Notch）signaling pathway， mitogen-activated proteinkinase （MAPK） signaling pathway， etc. This article aims to provide reference for the treatment of breast cancer by Chinese medicine.
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Objective To analyze the effects of different N stages,surgical treatment,lymph node dissection and combined chemoradiotherapy on the prognosis of intrahepatic cholangiocarcinoma (ICC).Methods The clinical data and follow-up results of 4 555 ICCs in the SEER database were retrospectively analyzed.Including 3 710 patients with N0 phase and 845 patients with N1,all patients included complete TNM staging information,survival time and survival status information,surgical related information and radiotherapy and chemotherapy treatment information.The survival curve was described by Kaplan-Meier method.The survival of 120 months was described.The hypothesis test was performed by Log-rank test.The overall prognosis of patients with different Nstage ICCs was observed.Different surgical methods,lymph nodes were removed,and postoperatively.The effect of chemoradiotherapy on the prognosis of patients with different N-stage ICC.Measurement data with skewed distribution were expressed as medians,and count data were expressed as percentages.Results The median survival time of N1 patients was 12 months while 15 months in N0 patients.In N0 patients,the median survival time was 8 months of no operation performed patients,26 months of local tumor destruction patients,and 45-59 months of surgical treatment performed patients.In N1 patients,the survival time was 9 months,26 months and 14-22 months of no operation performed,local tumor destruction and surgical treatment performed patients,respectively.In the N0 stage,the median survival time was 37 months for lymph node dissection not performed patients,and the median survival time for lymph node dissection patients was 46-55 months.In N1 patients,the median survival time was 26 months and 18-20 months for without or with lymph node dissection patients.In the N0 stage,the median survival time was 41-42 months for without chemo-or radio-therapy,and it was 43-46 months for with chemo-or radio-therapy patients.In the N1 stage,the median survival time 10-17 months and 23 months for without or with chemo-or radio-therapy patients.Conclusions The prognosis of patients with N1 in ICC is significantly worse than that in patients with N0.Surgery is an effective method for the treatment of ICC.At the same time,routine lymphadenectomy should be recommended.Patients with N1 are recommended for radiotherapy and chemotherapy.
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Objective: To assess the efficacy and safety of vaginal elimination in the treatment of giant stage IIIB cervical squamous cell carcinoma (SCC). Methods: From January 2016 to June 2017, clinical data of 49 patients with giant stage IIIB cervical SCC in Chongqing University Cancer Hospital were retrospectively analyzed. Survival and influencing factors were analyzed using the Kaplan-Meier method and multivariable Cox model. Results: After a median 36.0-month follow-up, the complete remission, local recurrence, and distant metastasis rates were 83.7% (41/49), 4.1% (2/49), and 34.7% (17/49), respectively. The overall survival (OS) rate, disease-free survival rate, distant metastasis-free survival (DMFS) rate, and local control rate (LCR) were 76.6%, 26.7%, 26.7%, and 77.8%, respectively. The occurrence rates of acute grade 3-4 adverse hematological events, diarrhea, frequency of urination, late grades 3-4 adverse rectitis events, and cystitis were 40.82% (20/49), 20.41% (10/49), 6.12% (3/49), 20.41% (10/49), and 8.16% (4/49), respectively. Cox analysis showed that the duration of radiotherapy affected OS and LCR (P<0.05), the dose of EQD2 affected DMFS and LCR (P<0.05), and the recurrence rate of SCC that persisted despite concurrent radiotherapy and chemotherapy was 61% (11/18). Conclusions: Patients with giant stage IIIB cervical SCC benefit from vaginal elimination combined with radiotherapy and chemotherapy; however, adverse reactions in the rectum and bladder increase, and thus, individualized treatment is recommended. The duration of radiotherapy is an independent factor for the prognosis of cervical cancer. SCC can be used for follow-up and monitoring cervical cancer recurrence.
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Objective@#To analyze the effects of different N stages, surgical treatment, lymph node dissection and combined chemoradiotherapy on the prognosis of intrahepatic cholangiocarcinoma (ICC).@*Methods@#The clinical data and follow-up results of 4 555 ICCs in the SEER database were retrospectively analyzed. Including 3 710 patients with N0 phase and 845 patients with N1, all patients included complete TNM staging information, survival time and survival status information, surgical related information and radiotherapy and chemotherapy treatment information. The survival curve was described by Kaplan-Meier method. The survival of 120 months was described. The hypothesis test was performed by Log-rank test. The overall prognosis of patients with different N-stage ICCs was observed. Different surgical methods, lymph nodes were removed, and postoperatively. The effect of chemoradiotherapy on the prognosis of patients with different N-stage ICC. Measurement data with skewed distribution were expressed as medians, and count data were expressed as percentages.@*Results@#The median survival time of N1 patients was 12 months while 15 months in N0 patients. In N0 patients, the median survival time was 8 months of no operation performed patients, 26 months of local tumor destruction patients, and 45-59 months of surgical treatment performed patients. In N1 patients, the survival time was 9 months, 26 months and 14-22 months of no operation performed, local tumor destruction and surgical treatment performed patients, respectively. In the N0 stage, the median survival time was 37 months for lymph node dissection not performed patients, and the median survival time for lymph node dissection patients was 46-55 months. In N1 patients, the median survival time was 26 months and 18-20 months for without or with lymph node dissection patients. In the N0 stage, the median survival time was 41-42 months for without chemo- or radio-therapy, and it was 43-46 months for with chemo- or radio-therapy patients. In the N1 stage, the median survival time 10-17 months and 23 months for without or with chemo- or radio-therapy patients.@*Conclusions@#The prognosis of patients with N1 in ICC is significantly worse than that in patients with N0. Surgery is an effective method for the treatment of ICC. At the same time, routine lymphadenectomy should be recommended. Patients with N1 are recommended for radiotherapy and chemotherapy.
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Background: The aim of the study was to determine the distribution of oropharyngeal malignancies in terms of age, sex,personal habits, symptoms, site, histopathological type, and differentiation; and the modes of treatment adopted and its results.Materials and Methods: A total of 68 patients treated previously in the Department of Ear, Nose, and Throat of MNR MedicalCollege and Hospital were included in this study. Patients of all age groups and gender were included in the study. Patients withpersistent mass of the neck or throat or with symptoms suggesting oropharyngeal cancer were included in the study. Patientswith symptoms of chronic throat pain, difficulty swallowing, weight loss, earache, voice change, and blood-tinged saliva wereincluded in the study. Patients with severe cardiac, renal and pulmonary diseases were excluded from the study. Patientswith immunodeficiency diseases were excluded from the study. All the patients were initially evaluated by a detailed medicalhistory and comprehensive head and neck examination, which included flexible endoscope examination of the pharynx andlarynx in an outpatient department setting. Patients with suspicious looking lesions (tumors) of the oropharynx were biopsiedfor histopathological evaluation. All patients with a confirmed diagnosis of oropharyngeal squamous cell carcinoma weresubjected to evaluation by a multidisciplinary treatment team. Imaging was done to evaluate the primary tumor, involvementof lymph nodes in the neck, and for evidence of metastatic cancer spread beyond the head and neck. The patients weresubjected to either computed tomography scan or magnetic resonance imaging of the neck to evaluate the pharynx and lymphnodes in the neck.Observations and Results: Among the 68 patients, there were 41 males (60.29%) and 27 females (39.70%), with a male tofemale ratio of 1.51: 1. The mean age was 55.63 ± 5.70 years. Thirty-seven patients (54.41%) were in 55–65 years, 24 patients(35.29%) in 45–55 years, and 7 patients (10.29%) were aged above 65 years. Malignant tumors of the tonsil were observedin 21/68 (30.88%), posterior one-third of the tongue in 17/68 (25%), soft palate in 10/68 (14.70%), valleculae in 10 (14.70%),and suprahyoid epiglottis in 6 (8.82%), and posterior pharyngeal wall in 4 (105.88%) of the patients.Conclusions: Oropharyngeal cancers are one of the most common malignant tumors of the aero-digestive tract. Males aremore commonly affected than females and usually in the 5th–6th decade of life. The incidence is rising in females also becauseof using smokeless tobacco products. The most common site was tonsil followed by posterior one-third of the tongue; the leastcommon site was posterior pharyngeal wall. Well-differentiated carcinoma was the most common histopathological finding.
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Lateral lymph node metastasis is a common problem in the diagnosis and treatment of patients with low rectal cancer. Eastern and western scholars are still controversial about the combination of lateral lymph node dissection in TME surgery for middle and low rectal cancer.The study of correlation between laparoscopic or robotassisted lateral lymph node dissection and open surgery is still in retrospective analysis, and prospective cohort studies are needed to further confirm their superiority. Whether neoadjuvant radiochemotherapy can replace lateral lymph node dissection is still inconclusive, and it is related to the cognition that the lateral lymph node metastasis belongs to the regional or the systemic metastasis of the oriental and occidental scholars.
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Objective To investigate the prognostic factors affecting early breast cancer patients with conserving surgery and discuss the influences of chemoradiation sequence on treatment efficacy.Methods We retrospectively analyzed 191 cases of early breast cancer after breast conservation surgery in the second hospital of Dalian medical university,from January 1,2006 to December 31,2015.According to the treatment order,they were divided into radiotherapy group,chemotherapy group and sandwich group.There were 32 patients in the radiotherapy group,107 patients in the chemotherapy group,and 52 patients in the sandwich group.The sandwich group was treated with chemotherapy-radiotherapy-chemotherapy.The factors were analyzed independently from the patients' age,menopausal status,pathology type,tumor size (T1,T2),axillary lymph node,molecular type of breast cancer,the interval between surgery and radiation,vascular tumor emboli.Regression model was used to find the risk factors of early stage breast cancer patients with conserving surgery.The 5-year LRR and 5-year OS was compared among radiotherapy-first group,chemotherapy-first group,the sandwich group in patients with high risk factors,and the factors associated with the prognosis of patients were analysed.Results The Multivariate Cox Regression model showed that tumor size,axillary lymph node,vascular tumor emboli,the interval between surgery and radiation were independent risk factors associated with 5-year OS.Among patients with T1 and T2 stage in radiotherapy-first group,chemotherapy-first group,sandwich group,there was no statistical difference in 5-year LRR or 5-year OS (P ＞ 0.05).Among patients with N0 stage in radiotherapy first group,chemotherapy first group,sandwich group,5-year LRR were not statistically different (P ＞ 0.05).For patients with N1 stage in chemotherapy-first group and the sandwich group 5-year LRR were with statistical difference(x2 =4.813,P =0.028).OS were without statistical difference (P ＞ 0.05).In patients with vascular tumor emboli in radiotherapy-first group,chemotherapy-first group,the sandwich group,5-year LRR were without statistical difference (5.3％,9.2％,vs.18.1％,P ＞ 0.05),OS were statistically different (61.5％,90.1％ vs.87.2％,x2 =6.282,P =0.043).For patients without vascular tumor emboli,there was no statistical difference in 5-year LRR (P ＞ 0.05).For patients started radiation within 6 months after surgery in radiotherapy-first group,chemotherapy-first group,the sandwich group,5-year LRR were without statistical difference (P ＞ 0.05).However,patients in chemotherapy-first group the time interval surgery and radiation ≤6 months vs.＞6 months 5-year LRR was 5.2％ and 14.1％ (x2 =4.886,P=0.027),5-year OS were 96.9％ and 85.7％ (x2 =5.758,P =0.038).Conclusions Clinical treatment is based on individualized options.For patients with negative axillary lymph nodes,but high risk factors for local recurrence,radiotherapy may be performed firstly.For high-risk patients with axillary lymph node metastasis or vascular tumor embolus,chemotherapy should be started early and radiotherapy may be followed,but not more than 6 months.
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Objective To explore the change and clinical significance of the serum carcinoembryonic antigen (CEA)and carbohydrate antigen 724(CA724)in patients with rectal cancer before and after neoadjuvant ra-diotherapy and chemotherapy.Methods The serum levels of CEA and CA724 of 30 patients with rectal carci-noma were detected by electrochemiluminescence method and were compared with those in 30 healthy people. Results The serum levels of CEA and CA724 in rectal carcinoma patients before neoadjuvant radiotherapy and chemotherapy were significantly higher than those in the healthy people,the difference was statistically significant(P<0.05).The serum levels in complete remission and partial remission patients after eight-week neoadjuvant radiotherapy and chemotherapy were significantly lower than those before treatment,the differ-ence was statistically significant(P<0.05),and the reduction levels were obviously higher than those in the stable group,the difference was statistically significant(P< 0.05).The CEA and CA724 levels in the stable treatment patients were also lower than those of before neoadjuvant radiotherapy and chemotherapy,the difference was statistically significant(P<0.05).The serum levels in the progression group were higher than those of before treatment(P<0.05).The serum levels of CEA and CA724 before neoadjuvant radiotherapy and chemotherapy existed a positive correlation(r=0.862,P=0.000).Conclusion The serum levels of CEA and CA724 in rectal cancer are highly expressed,suggesting that both of them are closely related to the occur-rence and development of rectal carcinoma,the measurement of the serum level changes of CEA and CA724 in patients with rectal cancer before and after treatment contributes to estimate the efficacy of neoadjuvant radio-therapy and chemotherapy and tumor progression.
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Lung blood is one of the important concepts of TCM. The functions of lung are regulating qi and body fluid, connecting all vessels, and passing waterway, while the disorders leading to syndrome differentiation of related diseases emphasize lung qi and lung yin, but seldom mention lung blood. In modern studies, Western scholars found that the lungs are closely related to the formation of blood cells, suggesting that pulmonary blood has important clinical significance. Observation found that the pathological function and transformation of TCM and Western medicine involved in pulmonary blood are particularly evident after radiotherapy and chemotherapy. Based on this, this article elaborated the treatment of tumor after radiotherapy and chemotherapy based on pulmonary blood syndrome, and provided new ideas and methods for the treatment of integrated traditional Chinese and Western medicine for tumors.
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Objective To investigate the protective effect of Addie on cardiac injury induced by radiotherapy and chemotherapy in patients with cervical cancer.Methods 74 cases of cervical cancer were collected from the oncology department of Zhousha Hospital, those were treated with surgery and radiotherapy and chemotherapy according to postoperative staging and classification of cases.The patients were randomly divided into the experimental group and the control group, with 37 cases in each group.Control group received leukogenic and antiemetic treatment,the experimental group were given Addie injection 100 mL intravenous drip on the basis of the control group, one times per day,10 days as one courses, and two groups were all received 6 courses of treatment.Atthe end of treatment, the condition of heart function, left ventricular ejection fraction, left ventricular end diastolic diameter, 6 minutes walk test, myocardial enzymes, troponin T, C reactive protein /Barhel quality of life score index, EORTC-QLQ score and the incidence of adverse reactions were detected and compared with two groups.Results After treatment, the cardiac function of the experimental group was significantly better than that of the control group (P<0.05).After treatment,LVEDD of two groups decreased (P<0.05), LVEF, 6 minutes walk test distance increased (P<0.05),and LVEDD of experimental group was lower than control group (P<0.05), LVEF, 6 minutes walk test distance higher (P<0.05).After treatment, creatine kinase and creatine kinase levels were increased in two groups (P<0.05).Compared with the control group, the level of creatine kinase and creatine kinase in experimental group were higher(P <0.05).After treatment,the levels of troponin T and C reactive protein in two groups were decreased ( P <0.05 ) .Compared with the control group, the levels of troponin T and C reactive protein in experimental group were lower (P<0.05).After treatment,the scores of Barhel index and EORTC-QLQ score of two groups were significantly higher than before treatment, and the quality of life of the experimental group was significantly higher than that of control group ( P <0.05 ) .There was no significant difference in the incidence of adverse reactions between two groups.Conclusion Addie has an obvious protective effect on cardiac injury induced by radiotherapy and chemotherapy in patients with cervical cancer, and can improve the quality of life of patients.
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Objective To investigate the efficacy of preoperative concurrent radiotherapy and chemotherapy in middle and low rectal cancer.Methods From October 2012 to September 2016,64 patients with middle and low rectal cancer underwent surgical treatment,were randomly divided into two groups,the treatment group 32 cases,the application of simultaneous preoperative radiotherapy and chemotherapy and surgery,control group of 46 patients,only the application of surgical treatment.After treatment,the efficacy,tumor decline,adverse reactions,serum CEA levels,the lower edge of the tumor to the anal distance,the longest diameter of the tumor and quality of life improvement were compared between two groups,and compared the local recurrence and survival of 2 groups in 3 and 5 years.Results The total effective rate of the treatment group was 78.13％,the rate of tumor decline was 87.5％,the improvement rate of quality of life 84.38％,the survival rate of 3 years and 5 years were 90.63％and 75％(19.14±8.52)ng/mL,the distance from the lower edge of the tumor to the anal margin was(7.88±2.07)cm,and the longest diameter of the tumor was(2.24±1.15)cm(P<0.05).The local recurrence rates were 6.25％and 15.63％in 3 years and 5 years,which were all lower than those in the control group(P<0.05).The side effects after radiotherapy and chemotherapy in the treatment group were(31.8％),nausea and vomiting(46.88％),radioactive pancreatitis(71.88％),neurotoxicity(3.13％),liver function abnormality(31.25％),leukopenia(25.00％),hemoglobin reduction),Diarrhea(87.5％),the vast majority of Ⅰ～Ⅱ degrees,the corresponding treatment were relieved.Conclusion The clinical curative effect of preoperative concurrent chemoradiation and radiotherapy of middle and low rectal cancer is significant,which has clinical value.
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Objective To investigate the Shenmai injection for the inhibition of hepatic and renal toxicity and leukocyte disorder during chemoradiotherapy in the women with advanced breast cancer. Methods 58 cases of female breast cancer patients with stage Ⅳ were selected and randomly divided into 2 groups, 29 cases of each group, and patients were treated with 5-hydroxytryptamine (5-HT3) receptor antagonists and white blood cell growth hormone and other conventional therapy, the control group received gemcitabine plus cisplatin chemotherapy, 28d for 1 cycles, the treatment group received more with Shenmai injection, interval was 15d, 2 groups were treated for 3 cycles. Levels of peripheral blood T lymphocyte subsets, cytokine levels and liver and kidney function, quality of life and clinical efficacy were compared. Results Compared with before treatment, levels of CD3+, CD4+ and CD4+/CD8+ in control group decreased (P<0.05), levels of CD3+, CD4+ and CD4+/CD8+ in treatment group increased (P<0.05), levels of CD8+ decreased(P<0.05), levels of IFN-γ, IL-2 and TNF-α increased(P<0.05), levels of IL-6 decreased(P<0.05), scores of KPS increased(P<0.05), scores of FACT-B decreased(P<0.05), levels of ALT, AST, BUN increased(P<0.05), and levels of CCr, WBC counts decreased(P<0.05), and compared with the control group, levels of CD3+ , CD4+ and CD4+/CD8+ in the treatment group were higher(P<0.05), levels of CD8+ were lower(P<0.05), levels of IFN-γ, IL-2 and TNF-α were higher(P<0.05), levels of IL-6 were lower(P<0.05), and the total efficiency was higher(P<0.05), levels of ALT, AST, BUN were lower (P<0.05), and levels of CCr, WBC counts were higher (P<0.05). After treatment, the efficacy of treatment group was higher than that of control group(Z=-2.142,P=0.032<0.05). Conclusion Shenmai injection can improve the efficacy of radiotherapy and chemotherapy in patients with advanced breast cancer, and it can effectively inhibit the liver and kidney damage and leukocyte disorder.
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Objective To evaluate the life quality of patients with nasopharyngeal carcinoma after intensity modulated radiotherapy and chemotherapy. Method Using phenomenological research method, we interviewed 10 patients repeatedly to explore their somatization, psychological changes as well as the effect on quality of life. Result The life quality of patients with nasopharyngeal carcinoma after intensity modulated radiotherapy and chemotherapy were affected tremendously , characterized by intense psychological stress, side effects from radiochemotherapy, hunger for emotional support, heavy burden of medical expenses, and the change of family and work roles. Conclusion Nursing staff should understand the mental feelings of patients, and provide supports for the patients psychologically, physically, from the economic, family and social points of view, so as to improve the life quality and physical and mental health of patients.
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Advanced non-small cell lung cancer(NSCLC)accounts for all NSCLC 45% . In recent years,chemotherapy combined with radiotherapy has become a new standard for NSCLC. On NSCLC radiothera-py and chemotherapy(CRCT),radiation total dose,fractionation method,different chemotherapy combined with radiotherapy have many details in the efficiency and toxicity tolerance,which are still in the exploration.
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Objective To investigate effect of famitinib malate on adverse reactions by radiotherapy and chemotherapy in treatment of advanced nasopharyngeal carcinoma and the nursing strategies.Methods From November 2011 to December 2013, 20 cases of advanced nasopharyngeal carcinoma in our hospital were treated with famitinib malate combined with radiotherapy and chemotherapy.During the treatment,we observed the adverse reactions and gave the symptomatic treatment.Results The rates of adverse reactions such as hypertension,renal toxicity,oral mucositis,myelosuppression,gastrointestinal reactions,nasal bleeding, abnormal liver function,and hand-foot skin reaction were 60.0%,70.0%,90.0%,100.0%,85.0%,10.0%,45.0%and 25.0%respectively.After symptomatic treatment,all completed the treatment.Conclusions The incidence rate of adverse reactions of famitinib malate combined with radiotherapy and chemotherapy for treating advanced nasopharyngeal carcinoma is high.Close monitoring and observation during treatment courses can ensure the successful completion of treatment.
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Objective To investigate the changes of peripheral blood parameters before and after radiotherapy and chemothera-py ,and establish an early index that can reflect the suppression and recovery of the bone marrow hematopoietic function in patients with tumor .Methods The white blood cell(WBC) ,neutrophils(NEU) ,the percentage of reticulocyte(Ret% ) and the immature re-ticulocyte fraction(IRF) of peripheral blood were detected by Sysmex XT-2000i automatic blood cell analyzer before and after radio-therapy and chemotherapy in 50 patients with tumor .Results Bone marrow function was suppressed after radiotherapy and chemo-therapy .Compared with the value before radiotherapy and chemotherapy ,IRF and Ret% were significantly decreased on the 3rd day after therapy which was 3 days earlier than the change of WBC and NEU ,the difference was statistically significant (P<0 .05) ,and compared with the value of the 10th day ,IRF began to rebound on the 15th day which was 5 days earlier than the change of Ret%and NEU ,the difference was statistically significant (P<0 .05) .Conclusion IRF can be served as an early and sensitive indicator in monitoring the suppression and recovery of bone marrow hematopoietic function in the patients with tumor during radiotherapy and chemotherapy .
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Objective: To evaluate the clinical effect and adverse reactions of radioactive seed interstitial brachytherapy com-bined with etoposide (EP) regimen concurrent chemoradiotherapy treatment for locally advanced non-small cell lung cancer. Methods:All 24 cases of locally advanced non-small cell lung cancer received three-dimensional conformal intensity modulated radiation therapy by using 6 MV X-ray to obtain 95%60-66 Gy/30-33 F planning target volume. All cases received radiation therapy five times a week. EP regimen chemotherapy concurrent with radiotherapy was given to 24 patients. The therapy included VP-16, 60 mg/m2 intravenous in-fusion for 1 d to 5 d, and DDP 50 mg/m2 intravenous infusion on the 1st, 8th, and 28th therapy day. Chemotherapy with EP regimen was given for four cycles, in which two cycles were given during radiotherapy and the remaining cycles were completed after radiotherapy. The patients were reexamined three months after concurrent chemoradiotherapy was completed. Patients with residual tumor, con-firmed via positron emission tomography/computed tomography, underwent 125I radioactive seed implantation interstitial brachytherapy to complement the dose of tumor. Results: The response rate was 83.3% (20/24); the local control rates of 3, 6, 9, 12, 18, and 24 months were 87.5% (21/24), 83.3% (20/24), 75.0% (18/24), 70.8% (17/24), 58.3% (14/24), and 50.0% (12/24). The median survival was 20.2 months. The one-year survival rate was 62.5%, and the two-year survival rate was 37.5%. The following main toxicities were observed:the incidence of radiation-induced lung injury was 25%;the incidence of radiation esophagitis was 33.3%;the incidence of grades Ⅰ to Ⅱ gastrointestinal reactions was 82.3%; the incidence of reducing neutropenia was 87.5%, in which the incidence of gradesⅠtoⅡwas 75.0%, gradeⅢwas 12.5%, and gradeⅣwas 0%. Conclusion:EP regimen concurrent radiotherapy and chemo-therapy combined with radioactive seed interstitial brachytherapy for locally advanced non-small cell lung cancer is effective and has few serious adverse reactions, thus making this approach worthy of promotion.
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Objective To study in targeted therapy of cancer drug endostar combined with radiotherapy and chemotherapy in the treatment of newly diagnosed patients with advanced non-small cell lung cancer, and find an effective combined treatment mode of advanced non-small cell lung cancer, so as to improve the survival rate and quality of life of patients with advanced lung cancer. Methods 18 patients with newly diagnosed advanced non- small cell lung cancer admitted to our hospital from July 2009 to February 2010 were randomly divided into 2 groups and treated with induction chemotherapy and 3D-CRT,9 cases in the experimental group (including Endostar), 9 cases in the control group, All of the patients'clinical symptoms, efficacy and toxicity in the two groups were observed. At the same time, nursing of radiotherapy, chemotherapy and targeted therapy was given to paients. Results The efficacy of the experimental group and the control group were 77.8% and 66.7%, the clinical remission rates of the experimental group and the control group showed no significant difference, both of the patients in the two groups had varying degrees of toxicity, but all of the them completed the treatment well under the holistic nursing and systematical health education by nurses. Conclusions Endostar combined with induction chemotherapy and three-dimensional conformal radiotherapy (3D-CRT) in the treatment of advanced non-small cell lung cancer can improve the efficacy and survival rate, and the quality of life, although there are some side effects, but can be alleviated by symptomatic treatment and care.
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The author reviewed the toxicity and complications of tumor radiotherapy and chemotherapy from the aspects of etiology,pathogenesis and differential treatment of TCM