经动脉灌注化疗治疗胰腺癌的临床疗效分析及大鼠胆道金属支架植入模型的建立
发布时间：2021-01-31 23:47
第一部分经动脉灌注化疗治疗胰腺癌的临床疗效分析背景与目的:胰腺癌是常见消化道恶性肿瘤,死亡率居恶性肿瘤第7位。约80%的患者诊断时已为进展期胰腺癌,失去根治性外科手术切除的机会,5年生存率仅约3%。全身化疗是进展期胰腺癌患者的首选治疗方法,但需要充分评估患者年龄、合并症、一般状态及耐受性。肿瘤消耗、疼痛、厌食、恶病质状态及化疗副作用等因素可导致部分进展期胰腺癌患者无法耐受全身化疗。此外,关键基因突变、信号通路调控异常及局部缺氧微环境等因素可引起化疗药物耐药,进而导致全身化疗失败。无法耐受全身化疗及全身化疗失败的胰腺癌患者治疗方法十分有限,预后极差,最佳支持治疗后患者的中位生存期仅约2.3个月。经动脉灌注化疗通过导管将化疗药物直接灌注到肿瘤供血动脉,提高了局部化疗药物浓度,同时降低了全身化疗药物浓度,并发症少,患者耐受性好。可控制原发肿瘤生长,减轻腹痛等症状,提高患者生活质量及延长患者生存期。对于合并肝转移的胰腺癌患者,经动脉灌注化疗过程中在腹腔干或肝总动脉灌注化疗药物是有效的治疗方法。此外,在全身化疗失败的患者中,全身化疗失败的药物在局部灌注仍可达到控制肿瘤生长的作用。因此,经动脉灌注...
【文章来源】：北京协和医学院北京市 211工程院校 985工程院校
【文章页数】：86 页
【学位级别】：博士
【部分图文】：
图１－１?ＴＡＩ肿瘤控制病例：患者女，４３岁，诊断胰腺癌伴肝转移，ＴＮＭ分期ＩＶ期：??ＥＣ０Ｇ评分１分
图１－２肿瘤无进展生存时间分析曲线??
?５００??Ｔｉｍｅ?（Ｄａｙｓ）??图１－２肿瘤无进展生存时间分析曲线??１００－１￣￣Ｃ???＊１＿?－４－?Ｃｅｎｓｏｒｅｄ??８０－?＇??ｒ?＼??。??°＼?ｓ?￣ｉ??Ｔｉｍｅ?（Ｄａｙｓ）??图１－３患者生存分析曲线??２０??
【参考文献】：
期刊论文
[1]胰腺癌经动脉灌注化疗指南(草案)[J]. 李槐,闫东. 介入放射学杂志. 2012(05)
[2]GP方案胰腺区域性动脉灌注治疗晚期胰腺癌的临床观察[J]. 刘华强,李勇,黄瑞文,黄晓萍. 肿瘤基础与临床. 2008(06)
[3]103Pd-induced apoptosis of proliferative smooth muscle cells in bile ducts of dogs:significance and effects on related genes[J]. Gui-Jin He,Fa-Qiang Yu,Rong Wu,Qin-Yi Gao,Shu-He Xu,Hong Gao, Wei-Guo Jiang,Tao Jiang and Xian-Wei Dai Department of General Surgery,Second Affiliated Hospital(Shengjing Hospital),China Medical University,Shenyang 110004,China,Radiotherapy Center,Second Affiliated Hospital(Shengjing Hospital),China Medical University,Shenyang 110004,China,Pediatrics Surgery Laboratory,Second Affiliated Hospital(Shengjing Hospital),China Medical University,Shenyang 110004,China,Department of Pathology,Second Affiliated Hospital(Shengjing Hospital),China Medical University,Shenyang 110004,China;Isotope Unit,First Affiliated Hospital,China Medical University,Shenyang 110001,China;and Isotope Research Institute,China Institute of Atomic Energy,Beijing 100050,China. Hepatobiliary & Pancreatic Diseases International. 2007(05)
[4]103Pd radioactive stent inhibits biliary duct restenosis and reduces smooth muscle actin expression during duct healing in dogs[J]. Gui-Jin He, Qin-Yi Gao, Shu-He Xu, Hong Gao, Tao Jiang, Xian-Wei Dai and Kai Ma Department of General Surgery, Second Affiliated Hospital, China Medical University, Shenyang 110004, China. Hepatobiliary & Pancreatic Diseases International. 2006(04)
[5]Peripancreatic artery ligation and artery infusion chemotherapy for advanced pancreatic carcinoma[J]. 纪宗正,王永向,陈熹,吴涛. Chinese Medical Journal. 2003(01)
本文编号：3011785
【文章来源】：北京协和医学院北京市 211工程院校 985工程院校
【文章页数】：86 页
【学位级别】：博士
【部分图文】：
图１－１?ＴＡＩ肿瘤控制病例：患者女，４３岁，诊断胰腺癌伴肝转移，ＴＮＭ分期ＩＶ期：??ＥＣ０Ｇ评分１分
图１－２肿瘤无进展生存时间分析曲线??
?５００??Ｔｉｍｅ?（Ｄａｙｓ）??图１－２肿瘤无进展生存时间分析曲线??１００－１￣￣Ｃ???＊１＿?－４－?Ｃｅｎｓｏｒｅｄ??８０－?＇??ｒ?＼??。??°＼?ｓ?￣ｉ??Ｔｉｍｅ?（Ｄａｙｓ）??图１－３患者生存分析曲线??２０??
【参考文献】：
期刊论文
[1]胰腺癌经动脉灌注化疗指南(草案)[J]. 李槐,闫东. 介入放射学杂志. 2012(05)
[2]GP方案胰腺区域性动脉灌注治疗晚期胰腺癌的临床观察[J]. 刘华强,李勇,黄瑞文,黄晓萍. 肿瘤基础与临床. 2008(06)
[3]103Pd-induced apoptosis of proliferative smooth muscle cells in bile ducts of dogs:significance and effects on related genes[J]. Gui-Jin He,Fa-Qiang Yu,Rong Wu,Qin-Yi Gao,Shu-He Xu,Hong Gao, Wei-Guo Jiang,Tao Jiang and Xian-Wei Dai Department of General Surgery,Second Affiliated Hospital(Shengjing Hospital),China Medical University,Shenyang 110004,China,Radiotherapy Center,Second Affiliated Hospital(Shengjing Hospital),China Medical University,Shenyang 110004,China,Pediatrics Surgery Laboratory,Second Affiliated Hospital(Shengjing Hospital),China Medical University,Shenyang 110004,China,Department of Pathology,Second Affiliated Hospital(Shengjing Hospital),China Medical University,Shenyang 110004,China;Isotope Unit,First Affiliated Hospital,China Medical University,Shenyang 110001,China;and Isotope Research Institute,China Institute of Atomic Energy,Beijing 100050,China. Hepatobiliary & Pancreatic Diseases International. 2007(05)
[4]103Pd radioactive stent inhibits biliary duct restenosis and reduces smooth muscle actin expression during duct healing in dogs[J]. Gui-Jin He, Qin-Yi Gao, Shu-He Xu, Hong Gao, Tao Jiang, Xian-Wei Dai and Kai Ma Department of General Surgery, Second Affiliated Hospital, China Medical University, Shenyang 110004, China. Hepatobiliary & Pancreatic Diseases International. 2006(04)
[5]Peripancreatic artery ligation and artery infusion chemotherapy for advanced pancreatic carcinoma[J]. 纪宗正,王永向,陈熹,吴涛. Chinese Medical Journal. 2003(01)
本文编号：3011785
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