淋巴瘤缓解后出现胸腔积液、呼吸困难1例

The patient, male, 77 years old, was diagnosed to have non-Hodgkin's lymphoma (NHL) for 2 years and got chest distress and cough 5 days prior to the admission. In 2003, the patient was found to have left epididymis tubercle and left inguinal lump, accompanied with gross hematuria. After biopsy examination, NHL of diffuse large B-cell type, stage Ⅳ and CD20( + ), was diagnosed. He accepted 8 courses of chemotherapy with CHOP and Mabtherapy treatment from 2003. After 2 cycles of therapy, the mass was deflated and gross hematuria disappeared, then he attained complete remission at last.He completed the last chemotherapy on June 11, 2004.

Objective:Investigate the feasibility and effcacy of neoadjuvant chemoradiotherapy for locally advanced gastric cancer.Methods: Intensity-modulated radiotherapy (IMRT), with 50/45 Gy in 25 fractions. The concurrent chemotherapy regimens included oral TS-1 plus oxaliplatin 40 mg/m2 intravenously weekly (10 patients) or TS-1 alone (120 mg/day, 25 patients). Surgical resection was performed within 6~8 weeks atfer the last day of radiotherapy. Results:No grade 4 toxicity recorded. hTe incidence of grade 3 toxicity is 11.4%: thrombocytopenia (5.7%), neutropenia (2.9%) and radiation esophagitis (2.9%). Pathological complete response 8.6% (3/35).Surgery-related complications consisted of anastomotic leakage in 2 patients (7.1%), infection in 3 (10.7%) and hemorrhage in 2 (7.1%). No postoperative mortality was recorded. hTe 1-year and 2-year overall survival (OS) rates were 88.3% and 59.6%respectively.Conclusion:In this study, neoadjuvant chemoradiotherapy showed an acceptable toxicity and promising efficacy in patients with locally advanced gastric cancer.

加用替吡法尼并不能进一步提高乳腺癌的病理完全缓解率

特异性法尼基转移酶抑制剂替吡法尼可以增强细胞毒性治疗药物的抗肿瘤效应,前期研究已经证明,替吡法尼在转移性乳腺癌患者中可发挥作用并且可以将新辅助化疗方案(阿霉素-环磷酰胺,AC)对乳腺癌的病理完全缓解率(pathologic complete response,pCR)提高到25％.为了进一步提高乳腺癌的pCR,Andreopoulou等进行了一项Ⅰ～Ⅱ期临床研究,给予两组pCR低的局部晚期乳腺癌患者[ER和PR阳性,HER/neu无过表达(A组)及炎性乳腺癌(B组)],在紫杉醇周疗序贯2周AC方案的新辅助化疗中加入替吡法尼,观察替吡法尼能否使pCR进一步提高.