背景与目的:华蟾素目前广泛应用于肿瘤的治疗中,由于在80年代上市,未进行临床Ⅰ期研究,无法确定其最大耐受剂量。因此本文旨在观察华蟾素治疗肝细胞癌、肺癌和胰腺癌的最大耐受剂量和不良反应,同时评价治疗疗效。方法:Ⅲ、Ⅳ期肝细胞癌...背景与目的:华蟾素目前广泛应用于肿瘤的治疗中,由于在80年代上市,未进行临床Ⅰ期研究,无法确定其最大耐受剂量。因此本文旨在观察华蟾素治疗肝细胞癌、肺癌和胰腺癌的最大耐受剂量和不良反应,同时评价治疗疗效。方法:Ⅲ、Ⅳ期肝细胞癌、非小细胞肺癌和胰腺癌接受华蟾素治疗,采用静脉滴注,连续14 d,21 d为一疗程。如果没有出现剂量限制性毒性,治疗将持续2个疗程。剂量递增的方案为:10、20、40、60、90和120 m l/(m2.d)。结果:入组15例患者(每个剂量组为3例)中,11例为肝癌,2例胰腺癌和2例肺癌。第五剂量组结束时没有发现剂量限制性毒性(DLT)。其中14例患者可评价疗效,6例(42.9%)为SD,8例(57.1%)为PD。在第一剂量组中,1例肝癌患者肿瘤缩小20%并维持11个月。结论:本研究最高剂量达到常规剂量的8倍,尚未出现剂量限制性毒性。部分患者获得了肿瘤缩小或稳定的疗效。展开更多
AIM:To examine whether acupuncture can prevent prolonged postoperative ileus(PPOI)after intraperitoneal surgery for colon cancer. METHODS:Ninety patients were recruited from the Fudan University Cancer Hospital,Shangh...AIM:To examine whether acupuncture can prevent prolonged postoperative ileus(PPOI)after intraperitoneal surgery for colon cancer. METHODS:Ninety patients were recruited from the Fudan University Cancer Hospital,Shanghai,China. After surgery,patients were randomized to receive acupuncture(once daily,starting on postoperative day 1, for up to six consecutive days)or usual care.PPOI was defined as an inability to pass flatus or have a bowel movement by 96 h after surgery.The main outcomes were time to first flatus,time to first bowel movement, and electrogastroenterography.Secondary outcomes were quality of life(QOL)measures,including pain, nausea,insomnia,abdominal distension/fullness,and sense of well-being. RESULTS:No significant differences in PPOI on day 4 (P=0.71)or QOL measures were found between the groups.There were also no group differences when the data were analyzed by examining those whose PPOI had resolved by day 5(P=0.69)or day 6(P= 0.88).No adverse events related to acupuncture were reported. CONCLUSION:Acupuncture did not prevent PPOI andwas not useful for treating PPOI once it had developed in this population.展开更多
Objectives： To evaluate the effects of the Chinese medicine （CM） five-element music on quality of life for senior and non-senior advanced cancer patients. Methods： With a randomized controlled trial, 170 advanced ...Objectives： To evaluate the effects of the Chinese medicine （CM） five-element music on quality of life for senior and non-senior advanced cancer patients. Methods： With a randomized controlled trial, 170 advanced cancer patients were randomly assigned to three groups： the CM five-element music group （68 patients）, the Western music therapy group （68 cases）, and the no music therapy group （34 cases）. All patients of 70 years old or older were considered seniors and the remaining patients younger than 70 years were considered non- seniors. Patients in the CM five-element music group listened to CM five-element music, the patients in the Western music group listened to Western music, and the patients in the no music group did not listen to music. A course of treatment was 3 weeks, with 30 rain each day, 5 days a week. The Hospice Quality of Life Index- Revised （HQOLI-R） and Karnofsky performance score （KPS） were measured in the three groups before and after treatment. The symptom diary score was measured in the three groups every 3 days, 7 times in total. Results： CM five-element music group showed a significant difference of HQOLI-R, KPS and symptom diary score with other groups （all P〈0.01）. There were significant differences of HQOLI-R, symptom diary score, and KPS after treatment in CM five-element music group and other groups in the non-senior subgroup （P〈0.05）. Additionally, there were significant differences in HQOLI-R and KPS after treatment among the three groups in the senior subgroup （P〈0.05）. Conclusions： CM five-element music therapy could improve the quality of life and KPS for senior and non senior advanced cancer patients, and it could improve subjective symptoms for non-senior advanced cancer patients.展开更多
Objective:Knowledge about the impact of metabolic disturbances and parenteral nutrition(PN)characteristics on the survival of cancer patients receiving PN is limited.We aimed to assess the association between clinical...Objective:Knowledge about the impact of metabolic disturbances and parenteral nutrition(PN)characteristics on the survival of cancer patients receiving PN is limited.We aimed to assess the association between clinical and PN characteristics and survival in colorectal-cancer patients receiving PN support.Methods:Our study included 572 consecutive colorectal-cancer patients who had received PN support between 2008 and 2013.Patient characteristics,body mass index,weight,medical/surgical history,indication for PN,PN data and survival were recorded.Associations between clinical and PN characteristics and survival were analysed with important confounding factors.Results:The final cohort included 437 evaluable patients,with a mean age of 57 years.Eighty-one percent of the study population had advanced stage of colorectal cancer.Unstable weight(weight change≥2.5%)prior to PN initiation[hazard ratio(HR)=1.41,P=0.023]was adversely associated with survival after adjusting for multiple factors including cancer stage.Bowel obstruction(HR=1.75,P=0.017)as a PN indication was associated with worse survival when compared with without bowel obstruction.Higher PN amino acid by ideal body weight(g•kg^(-1))(HR=0.59,P=0.029)was associated with longer survival,whereas a higher percentage of non-PN intravenous calories(HR=1.04,P=0.011)was associated with shorter survival independently of confounding factors.Conclusions:Body mass index and weight stability can be useful nutritional indices for survival prediction in cancer patients receiving PN.PN planning should take into account of non-PN calories to achieve optimal energy support and balance.Future research is needed to define optimal PN amino-acid requirement and energy balance.展开更多
文摘背景与目的:华蟾素目前广泛应用于肿瘤的治疗中,由于在80年代上市,未进行临床Ⅰ期研究,无法确定其最大耐受剂量。因此本文旨在观察华蟾素治疗肝细胞癌、肺癌和胰腺癌的最大耐受剂量和不良反应,同时评价治疗疗效。方法:Ⅲ、Ⅳ期肝细胞癌、非小细胞肺癌和胰腺癌接受华蟾素治疗,采用静脉滴注,连续14 d,21 d为一疗程。如果没有出现剂量限制性毒性,治疗将持续2个疗程。剂量递增的方案为:10、20、40、60、90和120 m l/(m2.d)。结果:入组15例患者(每个剂量组为3例)中,11例为肝癌,2例胰腺癌和2例肺癌。第五剂量组结束时没有发现剂量限制性毒性(DLT)。其中14例患者可评价疗效,6例(42.9%)为SD,8例(57.1%)为PD。在第一剂量组中,1例肝癌患者肿瘤缩小20%并维持11个月。结论:本研究最高剂量达到常规剂量的8倍,尚未出现剂量限制性毒性。部分患者获得了肿瘤缩小或稳定的疗效。
基金Supported by US National Cancer Institute (NCI) grants CA108084 and CA12153031
文摘AIM:To examine whether acupuncture can prevent prolonged postoperative ileus(PPOI)after intraperitoneal surgery for colon cancer. METHODS:Ninety patients were recruited from the Fudan University Cancer Hospital,Shanghai,China. After surgery,patients were randomized to receive acupuncture(once daily,starting on postoperative day 1, for up to six consecutive days)or usual care.PPOI was defined as an inability to pass flatus or have a bowel movement by 96 h after surgery.The main outcomes were time to first flatus,time to first bowel movement, and electrogastroenterography.Secondary outcomes were quality of life(QOL)measures,including pain, nausea,insomnia,abdominal distension/fullness,and sense of well-being. RESULTS:No significant differences in PPOI on day 4 (P=0.71)or QOL measures were found between the groups.There were also no group differences when the data were analyzed by examining those whose PPOI had resolved by day 5(P=0.69)or day 6(P= 0.88).No adverse events related to acupuncture were reported. CONCLUSION:Acupuncture did not prevent PPOI andwas not useful for treating PPOI once it had developed in this population.
基金Supported by the project of Chinese Geriatric Oncology Society of the"Eleventh five-year"Plan of Ministry of Civil Affairs(No.2008-47-2-45)
文摘Objectives： To evaluate the effects of the Chinese medicine （CM） five-element music on quality of life for senior and non-senior advanced cancer patients. Methods： With a randomized controlled trial, 170 advanced cancer patients were randomly assigned to three groups： the CM five-element music group （68 patients）, the Western music therapy group （68 cases）, and the no music therapy group （34 cases）. All patients of 70 years old or older were considered seniors and the remaining patients younger than 70 years were considered non- seniors. Patients in the CM five-element music group listened to CM five-element music, the patients in the Western music group listened to Western music, and the patients in the no music group did not listen to music. A course of treatment was 3 weeks, with 30 rain each day, 5 days a week. The Hospice Quality of Life Index- Revised （HQOLI-R） and Karnofsky performance score （KPS） were measured in the three groups before and after treatment. The symptom diary score was measured in the three groups every 3 days, 7 times in total. Results： CM five-element music group showed a significant difference of HQOLI-R, KPS and symptom diary score with other groups （all P〈0.01）. There were significant differences of HQOLI-R, symptom diary score, and KPS after treatment in CM five-element music group and other groups in the non-senior subgroup （P〈0.05）. Additionally, there were significant differences in HQOLI-R and KPS after treatment among the three groups in the senior subgroup （P〈0.05）. Conclusions： CM five-element music therapy could improve the quality of life and KPS for senior and non senior advanced cancer patients, and it could improve subjective symptoms for non-senior advanced cancer patients.
基金The University of Texas MD Anderson Cancer Center was supported in part by the NIH through Cancer Center Support Grant P30 CA016672.
文摘Objective:Knowledge about the impact of metabolic disturbances and parenteral nutrition(PN)characteristics on the survival of cancer patients receiving PN is limited.We aimed to assess the association between clinical and PN characteristics and survival in colorectal-cancer patients receiving PN support.Methods:Our study included 572 consecutive colorectal-cancer patients who had received PN support between 2008 and 2013.Patient characteristics,body mass index,weight,medical/surgical history,indication for PN,PN data and survival were recorded.Associations between clinical and PN characteristics and survival were analysed with important confounding factors.Results:The final cohort included 437 evaluable patients,with a mean age of 57 years.Eighty-one percent of the study population had advanced stage of colorectal cancer.Unstable weight(weight change≥2.5%)prior to PN initiation[hazard ratio(HR)=1.41,P=0.023]was adversely associated with survival after adjusting for multiple factors including cancer stage.Bowel obstruction(HR=1.75,P=0.017)as a PN indication was associated with worse survival when compared with without bowel obstruction.Higher PN amino acid by ideal body weight(g•kg^(-1))(HR=0.59,P=0.029)was associated with longer survival,whereas a higher percentage of non-PN intravenous calories(HR=1.04,P=0.011)was associated with shorter survival independently of confounding factors.Conclusions:Body mass index and weight stability can be useful nutritional indices for survival prediction in cancer patients receiving PN.PN planning should take into account of non-PN calories to achieve optimal energy support and balance.Future research is needed to define optimal PN amino-acid requirement and energy balance.
