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氣管、肺、食管多原發腫瘤一例

Observation of CT and Clinical Effect of Kallidinogenase on Progressive Cerebral Infarction in Different Imageology Styles

目的　探討尤瑞克林對不同結構性影像類型進展性腦梗死的CT與臨床效果。 方法　2007年3月－2011年6月按入院時不同結構性影像類型將進展性腦梗死分為大灶梗死、中灶梗死、小灶梗死及腔隙梗死4型，共235例，采用分層隨機分組的方法將患者分為尤瑞克林組（治療組）119例，對照組116例。兩組基礎用藥均為疏血通6 mL+生理鹽水250 mL靜脈滴注，胞磷膽堿0.5 g+生理鹽水250 mL靜脈滴注，阿司匹林0.1 g口服，以上用藥均為1次/d，連用4周。治療組同時給予生理鹽水100 mL+尤瑞克林0.15 PNAu靜脈滴注，對照組同時給予生理鹽水100 mL靜脈滴注，1次/d，連用7～14 d，兩組治療前后均測量梗死的最大層面最大梗死灶的長度與寬度，計算并記錄梗死面積；統計分析各型的臨床療效。 結果　① 梗死面積改變：治療前各亞型治療組與對照組梗死面積差異均無統計學意義（P＞0.05）；治療后，大灶梗死組、中灶梗死組、小灶梗死組中的治療組梗死面積均比治療前顯著縮小（P＜0.01），而對照組的梗死面積較治療前差異無統計學意義（P＞0.05）；腔隙梗死組中，治療組及對照組治療后梗死面積均無明顯改變（P＞0.05）。② 臨床療效：各亞型進展性腦梗死，治療組均取得優于對照組的效果；大灶梗死及中灶梗死的顯著進步率分別為47.6%和66.7%，而對照組的顯著進步率分別為0.0%和33.3%。 結論　大灶梗死組、中灶梗死組、小灶梗死組進展性腦梗死使用尤瑞克林治療后梗死面積均比治療前明顯縮小；各亞型進展性腦梗死使用尤瑞克林后臨床療效均優于對照組，尤其是大灶梗死及中灶梗死的臨床效果更加顯著。

Clinical Efficacy of Crizotinib for Patients with Anaplastic Lymphoma Kinase-positive Advanced Non-small-cell Lung Cancer

ObjectiveTo explore the therapeutic efficacy of crizotinib for patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small-cell lung cancer (NSCLC). MethodsWe retrospectively analyzed the clinical data of 31 ALK-positive NSCLC patients who received crizotinib treatment between November 2012 and May 2014 in the Department of Thoracic Oncology of West China Hospital. The median age of the patients was 51 years old, and the percentage of male and female patients was 45.2% and 54.8%, respectively. Among them, 74.2% were non-smokers, 74.2% had an ECOG performance status of 0-2. Histologically, adenocarcinoma was the highest proportion of 96.8%, and one (3.2%) patient had large cell carcinoma. Fifteen (48.4%) ALK-positive patients were given crizotinib in the first-line setting, and 16 (51.6%) accepted crizotinib in the second-line and beyond. ResultsThe objective response rate (ORR) of the patients treated with crizotinib was 61.3%, and the disease control rate (DCR) was 90.3%. The median progression-free survival (time) was 10.0 months [(95% CI (2.9, 17.0) months]. The difference of ORR and DCR between the patients given crizotinib in the first-line setting and the patients given crizotinib in the second-line or beyond was not statistically significant (P=0.716 and P=0.600, respectively). The most frequent treatment-related adverse events were increased aspartate aminotransferase/alanine aminotransferase (64.5%), nausea and vomiting (35.5%), leukopenia (16.7%), vision disorder (16.1%), edema (12.9%), and diarrhea (12.9%), and most toxicities were grade 1 and 2. ConclusionThis study shows that crizotinib can increase the objective response rate and disease control rate, prolong progression-free survival time in patients with advanced ALK-positive non–small-cell lung cancer. Crizotinib has relative fewer side effects and can be tolerated by the patients.