食管肿瘤/化学疗法

摘要： 目的 分析接受根治性调强放疗(IMRT)±化疗对颈、胸上段食管鳞癌患者的预后,并探讨选择性淋巴结照射(ENI)在其治疗中的意义.方法 收集河北医科大学第四医院放疗科接受IMRT±化疗的颈段和胸上段食管鳞癌患者309例进行回顾性研究,分析预后影响因素,并对接受不同照射方式患者进行分组,分析其疗效、不良反应等情况.结果 全组患者1、3、5年总生存(OS)率和无进展生存(PFS)率分别为76.7％、37.4％、19.3％和59.7％、27.4％、14.4％,中位数分别为26.8个月和15.5个月.多因素分析结果显示患者性别、cTNM分期、化疗为影响全组患者OS的因素(P=0.003、P＜0.001、P=0.022);性别、cTNM分期、照射方式为影响全组患者PFS的因素(P=0.016、P＜0.001、P=0.008).倾向得分匹配后患者1、3、5年OS和PFS分别为77.2％、39.3％、20.0％和62.0％、29.3％、15.4％,中位数分别为27.1个月和18.2个月.多因素分析结果显示患者性别、cTNM分期和化疗为影响其OS的因素(P=0.026、P＜0.001、P=0.017);cTNM分期和照射方式为影响其PFS独立性预后因素(P＜0.001、P=0.008).化疗亚组分析显示患者接受3～4周期化疗为佳.患者不良反应均以0-2级为主且可以耐受.结论 IMRT±化疗对颈段和胸上段食管鳞癌患者治疗有效;ENI可以提高患者的PFS.

摘要： 目的 分析食管癌同期放化疗的疗效和影响因素.方法 2006-2014年间接受3DRT食管癌患者307例,其中Ⅱ期73例、Ⅲ期234例.中位放疗剂量60 Gy,同期化疗方案为PF(166例)、TP(82例)、单药P(59例).采用Kaplan-Meier法计算OS、PFS率并Logrank法检验和单因素预后分析,Cox模型多因素预后分析.结果 3、5年样本量分别为130、45例,1、3、5年OS和PFS率分别为85.6％、53.8％、36.9％和74.6％、43.7％、33.1％,中位OS、PFS期分别为41.6、29.8个月.单因素分析显示影响OS和PFS因素为T分期、N分期、临床分期、病变部位、病变长度和化疗方案(P=0.007和0.013、0.000和0.000、0.000和0.000、0.002和0.000、0.141和0.005、0.018和0.165).多因素分析显示T分期、N分期、病变部位、化疗方案是影响OS因素(P=0.024、0.000、0.007、0.028),病变部位、病变长度、N分期是影响PFS因素(P=0.004、0.033、0.035).放疗剂量50～60、＞ 60～ 70 Gy的中位OS期和PFS期分别为47.4、37.8个月(P=0.469)和34.1、25.1个月(P=0.233).结论 Ⅱ—Ⅲ期食管癌同期放化疗可获得较好的生存,联合用药优于单药,低剂量与高剂量放疗疗效相近,不良反应可耐受.%Objective To summarize the outcomes and prognostic factors in esophageal cancer (EC) patients.Methods A total of 307 EC patients of stages Ⅱ-Ⅲ were treated with concurrent chemoradiotherapy in our hospital from September 2006 to July 2014.There were 73 patients with stage Ⅱ and 234 with stage Ⅲ.The radiotherapy dose was 50-70 Gy (median 60 Gy).Concurrent chemoradiotherapy were used with fluorouracil plus platinum (PF,166),paclitaxel plus platinum (TP,82) or platinum only (P,59).The Kaplan-Meier method was used to calculate overall survival (OS) and progression-free survival (PFS) rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis.The Cox regression model was used for multivariate prognostic analysis.Results The 1-,3-5-year OS and PFS rates were85.6％,53.8％,36.9％ and 74.6％,43.7％,33.1％,respectively.The median OS and PFS were 41.6 months and 29.8 months.The univariate analysis indicated that T stage,N stage,clinical stage,lesion location,lesion length and chemotherapy regimen were prognostic factors for OS and PFS (P=0.007 and 0.013,0.000 and 0.000,0.000 and 0.000,0.002 and 0.000,0.141 and 0.005,0.018 and 0.165).Multivariate analysis showed that T stage,N stage,lesion location and chemotherapy regimen were prognostic factors for OS (P =0.024,0.000,0.007 and 0.028),lesion location,lesion length and N stage were prognostic factors for PFS (P=0.004,0.033 and 0.035).The median OS and PFS for EC patients treated by total dose 50-60 Gy,＞60-70 Gy were 47.4 months,37.8 months (P=0.469) and34.1 months,25.1 months (P=0.0.233),therewere no statistic difference.Conclusions The outcome of EC patients treated with concurrent chemoratherapy could obtain a long-term survival,combination chemotherapy is superior to single drug,there are no statistical difference between high-dose and low-dose,and the acute toxic effects can be tolerated.

摘要： Objective To evaluate the survival and prognostic factors of esophageal cancer treated with definitive ( chemo ) radiotherapy by applying novel radiation techniques including three-dimensional conformal radiotherapy (3DCRT) or intensity-modulated radiotherapy (IMRT). Methods Clinical data of 2762 patients with non-operated esophageal squamous cell carcinoma who underwent definitive ( chemo ) radiotherapy from 2002 to 2016 in 10 hospitals were retrospectively analyzed.The prognostic factors were also identified and analyzed. Results The median follow-up time was 60. 8 months. The 1-, 2-, 3-and 5-year overall survival (OS) of all patients was 71. 4％,48. 9％,39. 3％,and 30. 9％,respectively.The 1-,2-,3-and 5-year progression-free survival (PFS) was 59.5％,41.5％,35.2％,and 30％,respectively.The median survival was 23 months.The median time to progression was 17. 2 months.Multivariate analysis demonstrated that age, primary tumor location, clinical stage, tumor target volume, EQD2 and treatment mode were the independent prognostic factors for OS.Primary tumor location,clinical stage,tumor target volume and EQD2 were the independent prognostic factors for PFS. Conclusions In this first large-scale multi-center retrospective analysis of definitive ( chemo) radiotherapy for esophageal squamous cell carcinoma in China, the 5-year OS of patients with esophageal squamous cell carcinoma is significantly improved by 3DCRT, IMRT combined with chemotherapy drugs. However, the findings remain to be validated by prospective clinical trials with high-level medical evidence.%目的 分析应用三维适形放疗(3DCRT)、调强放疗(IMRT)或以3DCRT、IMRT为基础的同步放化疗治疗食管癌根治性放疗患者的生存情况及预后影响因素.方法 回顾分析2002-2016年我国10所医疗中心符合纳入标准的2762例不宜手术或拒绝手术而接受根治性放疗的食管癌患者的病历资料.分析全部患者1、2、3、5年的总生存、无进展生存及预后影响因素.结论中位随访时间60.8个月.全部患者1、2、3、5年总生存率分别为71.4％、48.9％、39.3％、30.9％,无进展生存率分别为59.5％、41.5％、35.2％、30.0％.中位生存期为23.0个月,中位无进展生存期为17.2个月.多因素分析结果 显示年龄、原发肿瘤部位、临床分期、肿瘤体积、放疗剂量及治疗模式是影响总生存的因素(P=0.000～0.023),原发肿瘤部位、临床分期、肿瘤体积及放疗剂量是影响无进展生存的因素(P=0.000～0.002).结论 在应用3DCRT、IMRT新技术和化疗药物治疗的食管鳞癌患者的5年总生存率显著提高,对临床治疗有一定的参考价值.

摘要： 伴随着社会老龄化趋势的加剧,老年食管癌患者的比例在不断增加.鉴于老年患者的手术耐受性较差、合并症多等原因,放疗在老年食管癌的治疗中显得尤为重要.本文主要探讨老年食管癌综合治疗进展.%Along with the intensification of the aging trend,the proportion of elderly patients suffering from esophageal cancer has been ever increased.Radiotherapy plays a pivotal role in the treatment of esophageal cancer in the elderly patients considering their relatively poor tolerance of surgery and high risk of postoperative complications.In this review,the development in the comprehensive treatment of esophageal cancer in the elderly was summarized.

摘要： Objective To retrospectively analyze the value of postoperative adjuvant therapy in the treatment of stageⅢthoracic esophageal squamous cell carcinoma ( ESCC) . Methods From 2008 to 2011, a total of 395 patients with stageⅢthoracic ESCC undergoing radical resection were enrolled as subjects. In those patients.97 received surgery alone (S).212 postoperative adjuvant chemotherapy (POCT),and 86 postoperative radiotherapy (PORT).Comparison of categorical data was made by chi⁃square test. The survival rates were calculated by the Kaplan⁃Meier method. The log⁃rank test was used for between⁃group comparison and univariate analysis. Results All patients were followed up for at least 3 years.125 cases were followed up for at least 5 years. The 5⁃year overall survival ( OS) rates in patients treated with S,POCT and PORT were 17. 1%,29. 2% and 36. 4%,respectively (P=0. 000).POCT and PORT could mainly increased OS in patients of males.upper⁃and middle⁃segment,severe ahhesion at surgery.well⁃or middle⁃differentiation,stageⅢa andⅢb(P=0. 000⁃0. 049);whenever ages.tumor lesion,two⁃/three field esophagectomy.and the number of removal lymph nodes. PORT could improved OS also (P=0. 001⁃0. 047).POCT could also improve OS in patients of ages≤60, tumor lesion<6 cm and removal lymph nodes<10 ( P=0. 002⁃0. 049 ) . The 5⁃year progression⁃free survival (PFS) were 19. 0% with S,28. 8% with POCT,36. 4% with PORT,respectively (P=0. 012).PORT could improve PFS (P=0. 012);especially for patients of males,ages ≤60,upper⁃and middle segment ESCC,tumor lesion ≥6 cm,severe ahhesion at surgery,removal lymph node<10 and ≥10,well or middle differentiation,stageⅢa andⅢb(P=0. 001⁃0. 042).But POCT could not increased PFS (P=0. 119) . Conclusions In the treatment of patients with stage Ⅲ thoracic ESCC undergoing radical resection,both POCT and PORT can improve the OS rate, particularly in patients with stage Ⅲa or Ⅲb middle and upper thoracic ESCC, severe adhesion formation during surgery. and moderately or well differentiated squamous cell carcinoma. The DFS rate is improved in patients treated with PORT,but not in those treated with POCT.%目的：回顾性分析Ⅲ期胸段食管鳞癌根治术后辅助治疗的价值。方法收集2008—2011年间收治的胸段食管鳞癌根治术后Ⅲ期者395例，其中97例单纯手术、212例术后辅助化疗、86例术后放疗。应用Kaplan⁃Meier法计算生存率，组间比较行Logrank法检验和单因素分析。结果所有病例均随访满3年，125例随访满5年。全组单纯手术、术后辅助化疗和术后放疗者5年OS分别为17.1％、29.2％和36.4％（ P＝0.000）；术后辅助化疗或放疗均能提高男性、胸中上段癌、术中重度粘连、中高分化鳞癌、Ⅲa和Ⅲb 期者OS （ P＝0．000～0.049）；无论年龄≤60岁／＞60岁、食管病变长度＜6 cm／≥6 cm、两野或三野手术、清扫淋巴结＜10个／≥10个者，术后放疗均能提高 OS （ P＝0．001～0.047）；术后辅助化疗提高年龄≤60岁、病变长度＜6 cm和清扫淋巴结＜10个者 OS （ P＝0．002～0.049）。单纯手术、术后辅助化疗和术后放疗者5年PFS分别为19.0％、28.8％和36.4％，术后放疗高于单纯手术（ P＝0.012），尤其男性、年龄≤60岁、胸中上段癌、病变长度≥6 cm、清扫淋巴结＜10和≥10个、术中重度粘连、中高分化鳞癌、Ⅲa和Ⅲb 期者（ P＝0．001～0.042），而术后化疗比单纯手术不提高PFS （ P＝0.119）。结论Ⅲ期胸段食管鳞癌根治术后辅助化疗和术后放疗均能提高OS，尤其男性、胸中上段癌、术中重度粘连、中高分化鳞癌、Ⅲa和Ⅲb 期者；术后放疗也能提高PFS，而术后化疗不提高PFS。

摘要： Objective To analyze the prognosis of advanced esophageal carcinoma treated with paclitaxel and different platinum⁃based chemotherapy regimens plus intensity⁃modulated radiotherapy ( IMRT) , and to explore an optimal chemotherapy regimen. Methods A total of 242 patients with advanced esophageal carcinoma who were admitted to our hospital and treated with paclitaxel and cisplatin ( 68 patients), nedaplatin (85 patients), lobaplatin (58 patients), or oxaliplatin (31 patients) plus IMRT from 2008 to 2014 were enrolled as subjects. The prognosis of the four groups was analyzed after 2, 3, and ≥4 cycles of chemotherapy. The survival rates were calculated by the Kaplan⁃Meier method and analyzed by the log⁃rank test. The Cox model was used for the multivariate prognostic analysis. Results The sample number of 3 years was 168 cases. In all the 242 patients, the medium survival time was 31. 1 months and the 3⁃year overall survival ( OS) rate was 47. 4%. There was no significant difference in the 3⁃year OS rate between the cispaltin, nedaplatin, lobaplatin, and oxaliplatin groups ( 46. 2% vs. 56. 4% vs. 45. 7% vs. 29. 0%, P=0. 090) . The stratified analysis showed that the cisplatin, nedaplatin, and lobaplatin groups had a significantly higher OS rate than the oxaliplatin group ( 50. 1% vs. 29. 0%, P=0. 021 ) . There was no significant difference in the 3⁃year OS rate between patients receiving 2, 3, and≥4 cycles of chemotherapy ( 40. 1% vs. 49. 5% vs. 50. 8%, P=0. 264) . The multivariate analysis showed that esophageal tumor volume and the maximal size of metastatic lymph node were independent prognostic factors. Conclusions Combined with IMRT, paclitaxel plus cisplatin, nedaplatin, or lobaplatin⁃based chemotherapy achieves improved survival rates than paclitaxel plus oxaliplatin⁃based chemotherapy. Esophageal tumor volume and the maximal size of metastatic lymph node are independent prognostic factors.%目的：分析食管癌铂类药联合紫杉醇＋IMRT的预后，探讨较佳的化疗方案。方法选取2008—2014年间收治的242例紫杉醇联合顺铂（68例）、奈达铂（85例）、洛铂（58例）和奥沙利铂（31例）化疗＋IMRT 的中晚期食管癌患者，分析4个组以及化疗周期数2、3、≥4个的预后。用Kaplan⁃Meier方法计算生存率并Logrank检验，用Cox模型进行多因素预后分析。结果3年样本数168例。全组患者中位生存时间为31.1个月，3年生存率为47.4％。紫杉醇联合顺铂、奈达铂、洛铂和奥沙利铂＋IMRT的3年生存率分别为46.2％、56.4％、45.7％和29.0％（ P＝0.090）。分层分析发现紫杉醇联合顺铂＋奈达铂＋洛铂＋IMRT 的生存率高于联合奥沙利铂＋IMRT （50.1％∶29.0％， P＝0.021）；化疗周期数2、3、≥4个的3年生存率分别为40.1％、49.5％和50.8％（ P＝0.264）。多因素分析显示食管肿瘤体积和淋巴结转移最大径是影响预后的因素。结论紫杉醇联合顺铂或奈达铂或洛铂化疗方案＋IMRT的生存率高于联合奥沙利铂＋IMRT，食管肿瘤体积和淋巴结转移最大径是预后影响因素。

摘要： 目的 对IMRT同期化疗食管癌病例采用不同分期标准进行验证比较,探讨更准确、更适用的非手术治疗临床分期标准.方法 选取2008-2014年间就诊于本院242例IMRT化疗食管鳞癌患者的临床资料,用2009年中国分期、第6版分期和建议分期进行预后判断比较.Kaplan-Meier法计算生存率并Logrank检验,Cox模型预后分析.结果 3年样本数168例.全组患者3年生存率为47.4％,食管肿瘤体积和淋巴结转移最大径是影响预后的因素(P=0.000、0.000).中国分期和第6版分期T3、T4期生存曲线有交叉(P=0.696、0.594),中国分期的N1、N2期生存曲线有交叉(P=0.068);建议分期采用食管肿瘤体积的T分期、淋巴结转移最大径的N分期以及结合的临床分期,各期的生存曲线分离度较好(P=0.000、0.000、0.000).结论 采用食管肿瘤体积的T分期和淋巴结转移最大径的N分期结合进行IMRT化疗食管鳞癌的非手术临床分期能较好预测患者预后,简便易行.%Objective To compare different non-operative clinical staging criteria regarding their accuracy and feasibility in evaluation of patients with esophageal squamous cell carcinoma (ESCC) receiving concurrent intensity-modulated radiotherapy (IMRT) and chemotherapy.Methods A study was performed on clinical data from 242 ESCC patients who received concurrent IMRT and chemotherapy in our hospital from 2008 to 2014.Prognostic prediction was compared between the Chinese 2009 staging system,the 6th edition staging system,and a suggested staging system.The survival rates were calculated by the KaplanMeier method and analyzed by the log-rank test.A prognostic analysis was made by the Cox model.Results The 3-year sample size and overall survival rate were 168 and 47.4％,respectively.Esophageal tumor volume and the maximum diameter of metastatic lymph nodes were prognostic factors (P=0.000,0.000).An intersection of T3 and T4 survival curves was found in the Chinese staging system and the 6th version staging system (P=0.696,0.594),while an intersection of N1 and N2 survival curves was found in the Chinese staging system (P=0.068).The T staging based on esophageal tumor volume,N staging based on the maximum diameter of metastatic lymph nodes,and their combination could achieve a good separation of survival curves of different stages (P=0.000,0.000,0.000).Conclusions The T staging based on esophageal tumor volume combined with the N staging based on the maximum diameter of metastatic lymph nodes is an convenient non-operative clinical staging approach for prognostic prediction of ESCC patients receiving concurrent IMRT and chemotherapy.

摘要： 本发明提供一种用于减轻在癌化学疗法中引起的氧化应激和/或副作用、或者改善癌化学疗法中的营养状态的组合物，所述组合物含有下述的(a)～(f)的成分：(a)抗氧化剂、(b)选自维生素B

摘要： 本发明提供一种用于减轻在癌化学疗法中引起的氧化应激和/或副作用、或者改善癌化学疗法中的营养状态的组合物，所述组合物含有下述的(a)～(f)的成分：(a)抗氧化剂、(b)选自维生素B

摘要： 本发明属于药物制剂领域，涉及一种针对多药耐药肿瘤的靶向纳米递释系统及制备方法。本发明采用化学键合的方法将光敏剂焦脱镁叶绿酸a（PPA）键合在共聚物羟基化‑聚乳酸‑聚羟基乙酸(HO‑PLA‑PEG‑PLA‑OH)的两端,得产物光敏剂嵌合的聚乳酸‑聚羟基乙酸聚合物(PPA‑PLA‑PEG‑PLA‑PPA),然后用乳化溶媒蒸发法物理包载化疗药物紫杉醇制成双载药纳米递释系统（PPA NP‑PTX），在其表面修饰具有特异性靶向作用及细胞穿透作用的F3肽，制成具有双级靶向特性的光动力和化疗联合给药纳米递释系统。实验表明，本递药系统对耐药肿瘤细胞具有强大的杀伤作用，体内肿瘤靶向效果明显，对荷多药耐药肿瘤小鼠的治疗效果显著，本联合给药纳米系统具有临床应用前景。

摘要： 本发明指的是使用提高肿瘤细胞对放射疗法和/或化学疗法敏感性的物质。这是通过使用可以锁定或限制PINCH-1蛋白功能的物质，从而提高肿瘤细胞对放射疗法和/或化学疗法的敏感性而实现的。

摘要： 本公开中涉及抗PD‑1抗体联合化学疗法在制备治疗肿瘤的药物中的用途。具体而言，提供了PD‑1抗体或其抗原结合片段联合基于奥沙利铂的化学疗法方案在制备治疗患有非小细胞肺癌、乳腺癌、黑素瘤、肝癌、结直肠癌或肾癌的患者的药物用途。该方案的疾病控制率高达58.3％，展现联合用药的协同效应。

摘要： 公开了用于减少肿瘤生长、癌细胞迁移和与EGFR(表皮生长因子受体)和MET(肝细胞生长因子的受体酪氨酸激酶)的失调相关的各种其它癌症病理学(特别是在非小细胞肺癌中)的组合物，例如核酸、载体、细胞、动物模型等。

摘要： 本发明涉及二烷基三氮烯基支撑的雌激素和抗雌激素，它们适合作为治疗人体和动物的性器官癌的化疗药物使用。

摘要： 描述了包含光敏剂的金属有机层(MOL)和金属有机纳米片(MOP)。MOL和MOP还可以包括能够吸收X射线或其他电离辐射能量和/或闪烁的部分。可选地，光敏剂或其衍生物可以形成MOL或MOP的桥连配体。还描述了在光动力学疗法、X射线诱导的光动力学疗法(X‑PDT)、放射疗法(RT)、放射动力学疗法或放射疗法‑放射动力学疗法(RT‑RDT)中使用MOL和MOP的方法，该方法可以同时给予或不共同给予另一种治疗剂，例如化疗剂或免疫调节剂。

摘要： 本发明描述包含光敏剂的金属有机框架(MOF)。所述MOF还可以包括能够吸收X射线和/或闪烁光的部分。可选地，所述光敏剂或其衍生物可以形成所述MOF的桥连配位体。另外，所述MOF可以可选地在所述MOF的腔体或通道中包含无机纳米颗粒或可以与无机纳米颗粒组合使用。本发明还描述了在光动力疗法中或X射线诱导的光动力疗法中使用MOF和/或无机纳米颗粒的方法，其中伴随或不伴随一种或多种免疫治疗剂和/或一种或多种化学治疗剂的共施用。

摘要： 描述了含有通过包含二硫化物基团的接头与药物衍生物如抗癌药物衍生物连接的脂质部分的前药。还描述了涂覆有包含前药的脂质层的纳米颗粒，包含纳米颗粒的制剂以及纳米颗粒在单独或与其他药物化合物、靶向剂和/或免疫治疗剂组合治疗疾病如癌症的方法中的应用，免疫治疗剂例如靶向CTLA‑4、PD‑1/PD‑L1、IDO、LAG‑3、CCR‑7或其他途径的免疫抑制抑制剂，或靶向这些途径组合的多种免疫抑制抑制剂。可选地，纳米颗粒可以包含光敏剂或其衍生物，并可用于涉及光动力疗法的方法中。协同治疗效果由所公开的纳米颗粒和/或纳米颗粒制剂提供的多种形式的组合产生。