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Objective To evaluate the efficacy and safety of gefitinib combined with concurrent thoracic radiotherapy in the treatment of local - advanced non - small cell lung cancer with sensitive EGFR mutations. Methods From June 2015 to December 2016,fifty-six eligible patients in Chongqing Three Gorges Central Hospital were randomly assigned into two groups by one to one ratio,with 28 cases in each group.A group received treatment of gefitinib combined with concurrent thoracic radiotherapy, and B group adopted concurrent chemoradiotherapy. The toxic effects were recorded and all patients were followed up as defined by the study protocol.Primary study endpoints included:severe toxic effects,objective response rate and disease control rate,progression free survival and overall survival.Results Twenty-six patients in A group completed the study,and the severe toxic effects were as followed:interstitial pneumonia(3/26),radiation esophagitis(4/26),myelosuppression,skin rashes and gastrointestinal disruption. Twenty- eight patients in B group completed the study, and the severe toxicity included: interstitial pneumonia (4/26),radiation esophagitis(3/26),myelosuppression,skin rashes and gastrointestinal disruption.No toxicity higher than gradeⅢdeveloped in both two groups,and there were no statistically significant differences in incidence rates of interstitial pneumonia and radiation esophagitis between the two groups ( all P >0. 05 ). Moreover, there were no statistically significant differences in ORR and DCR between the two groups( ORR:61.5% vs.39.3% ,P=0.102;DCR:84. 6% vs. 71. 4% , P =0. 505 ). A group showed the benefit over B group in PFS ( 12. 45 months vs. 10.35 months,P=0.036).However,OS didn＇t reach and needed further follow-up.Conclusion The modality of gefitinib combined with concurrent thoracic radiotherapy in the treatment of local -advanced non -small cell lung cancer with sensitive EGFR mutations is safe and effective,and it yet needs further follow-up.
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Objective To evaluate the efficacy of recombinant human endostatin combined with TP(paclitaxel + cisplatin) in the treatment of advanced epidermal growth factor receptor (EGFR) squamous cell lung carcinoma.Methods From January 2012 to February 2015,100 patients with squamous cell lung carcinoma in Chongqing Three Gorges Central Hospital for medical treatment were selected as the subjects.According to different treatment methods,they were divided into single group (n =50) and combined group (n =50).The single group used the TP protocol and the combined group was treated with recombinant human endostatin on the basis of the TP protocol.The therapeutic effect was evaluated according to the Response Evaluation Criteria In Solid Tumors 1.1 (RECIST 1.1).The short-term effects,long-term effects,adverse reactions,hospitalization time and expenses were also analyzed.Results The objective effective rate in the combined group [52.0％ (26/50)] was significantly higher than that in the single group [16.0％ (8/50)],with a significant difference (x2 =14.429,P =0.007).The disease control rate in the combined group was higher than that in the single group (80.0％ vs.52.0％),with a significant difference (x2 =8.734,P =0.009).Compared with the patients in the single group,the median progression free survival (8.4 months vs.6.3 months)and overall survival (17.7 months vs.11.5 months) in the combined group were prolonged obviously,with significant differences (x2 =5.390,P =0.025;x2 =3.993,P =0.035).The incidence rates of adverse reactions in single group were basically the same compared with the combined group,and the difference was not statistically significant (all P ＞0.05).Compared with the single group,the hospitalization time in combined group was longer [(23.5 ± 2.8) weeks vs.(18.2 ± 3.5) weeks],and the expenses in combined group was higher [(112 453.9 ± 994.9) yuan vs.(87 821.4 ± 943.2) yuan],with significant differences (t =8.361,P ＜0.001;t =127.051,P ＜0.001).But the satisfaction of patients in combined group was significantly higher than that in single group (88.0％ vs.64.0％,x2 =4.210,P =0.017).Conclusion Recombinant human endostatin combined with TP regimen is effective in the treatment of advanced EGFR wild-type squamous cell lung carcinoma,and has a low incidence of adverse reactions.It is suitable for clinical application.
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Objective To observe the clinical curative effecand safety of ordinary intensity modulated and simplified intensi-ty modulated radiotherapy technique combined with transcathetearterial chemoembolization (TACE) fotreating primary hepaticancer(PHC) .MethodTotally 85 caseof Phwere randomly divided into the observation group (n=43) and the control group (n=42) .The observation group adopted the sequential therapy of TACE combined with the simplified intensity modulated radio-therapy(sIMRT) and the control group adopted the sequential therapy of TACE combined with the conventional intensity-modula-ted radiation therapy (cIMRT) .The shorterm curative effect,progresfree survival (PFS) ,overall survival (OS) ,and toxicity and adverse reactionwere observed in the two group.Result85 casewere followed up according to the requirement,2 casein the control group did noparticipated in the effecevaluation due to the unfinished radiotherapy projec.There were no statistically significandifferencebetween the two groupin the shorterm effect(55 .81% v.52 .50% ) ,PFS(25 .51 weekv.28 .06 weeks) and OS(78 .82 weekv.83 .22 weeks) (P＞0 .05) .The main toxicity and adverse reactionwere similain the two group,each i-tem had no statistical difference between the two group(P>0 .05) .Conclusion sIMRcan obtain the curative effecand progno-sisimilato cIMRwithouincreasing the toxicity and adverse reaction,and reducethe trend developing radioactive livedam-age ,which can be used athe routine replace mode of intensity modulated radiotherapy projecof PHC.
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Objective To evaluate the effiacy and adverse reactions of domestic gemcitabine combined with lobaplatine in salvage treatment of taxanes-refractory advanced lung squamous canceroma.Methods 71 patients with squamous carcinoma of lung,all had been failer to combined chemotherapy with taxanes treatment before,received the treatment with domestic gemcitabine (1 000mg/m2,d1,8) combined with lobaplatine (30mg/m2,d2),21-28 days as a cycle,at least 2 cycles should been recieved.The therapeutic efficacy was evaluated after 2 cycles of chemotherapy,according to RECIST1.0 standard.Results All of 175 cycles had been observed.In terms of the treatment efficacy,68 patients could be evaluated objectively of 71 cases patients,partial response (PR) was 15 cases (22.0％),stable disease(SD) was 18 cases(26.4％),with an overall response rate(RR) was 22.0％ (15/68),disease control rate (DCR) was 48.5 ％ (33/68).The median time to progression (TTP) was 13.6 weeks.the median survival time (OS) was 7.9 months.One year survival rate was 42.6％ (29/68).On 71 cases for a total of 175 cycles of chemotherapy,the major toxic reaction was hematological toxicities,including myelosuppression about 38.3％ (67/175) for grade Ⅲ and Ⅳ.Conclusion The combination treatment of domestic gemcitabine plus lobaplatin is a feasible and active scheme in salvage treatment of taxanes-refractory advanced quamous carcinoma of lung.
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OBJECTIVE:To study the effect of comprehensive psychotherapy on psychology of cancer patients received chemotherapy or radiotherapy. METHODS:77 cancer patients received chemotherapy or radiotherapy were divided into two groups. Both groups received routine chemotherapy or radiotherapy. Intervention group(n=40)were additionally given comprehensive psychotherapy,i.e. cognitive therapy,psychological persuasion and relaxation training. Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were applied to evaluate all patients one week before intervention and one month after comprehensive psychotherapy. RESULTS:SAS and SDS scores of intervention group were significantly lower than that of control group after treatment(P0.05). CONCLUSION:Comprehensive psychotherapy can improve the mental state of patients with can-cer.