腫瘤科

“原以為得了晚期宮頸癌，不能手術(shù)等于判了死刑，不曾想貴院腫瘤科的大夫竟然妙手回春，積極治療挽救了我，給了我第二次生命，請幫我向你們科的崔主任、姜醫(yī)生再說一聲謝謝”。2018年元月中旬的一個早上，66歲的顧奶奶與腫瘤科放療中心護(hù)士長干小芹深情的說道。原來，2017年4月份，老人因“下腹墜通不適，陰道不規(guī)則流血”，在上海紅房子醫(yī)院診斷為“宮頸鱗狀細(xì)胞癌”，已達(dá)宮頸癌三期，失去了根治性手術(shù)治療機(jī)會，只能做腫瘤放化療。由于路途遙遠(yuǎn)，照應(yīng)困難，療程漫長，顧奶奶一家人沮喪的回到了姜堰，抱著試試看的心理，來到泰州二院腫瘤科就醫(yī)。腫瘤科副主任醫(yī)師姜勇認(rèn)真細(xì)致了解病情后，將患者收住入院。入院后，腫瘤科主任崔林立即組織科內(nèi)討論，制定了詳細(xì)的診療方案和計劃。經(jīng)過1個半月的放療和4個周期的化療，顧奶奶的病情得到了好轉(zhuǎn)，不僅下腹墜痛和陰道出血癥狀沒有了，而且宮頸和盆腔的腫瘤病灶也神奇消失了。患者后續(xù)內(nèi)窺鏡檢查和宮頸刮片檢查均未檢出腫瘤病灶，CT提示盆腔病灶消失。最近1次于2019年1月16日到泰州二院復(fù)查宮頸細(xì)胞學(xué)檢查診斷：未見惡性細(xì)胞。目前，顧奶奶治療結(jié)束已經(jīng)1年半，沒有放射性膀胱炎、放射性腸炎、白細(xì)胞血小板下降等并發(fā)癥發(fā)生。放療中心主任柯軍介紹，隨著腫瘤放化療技術(shù)的不斷進(jìn)步，不能手術(shù)的中晚期宮頸癌已不是不治之癥，放療其實(shí)是一種隱形的“手術(shù)刀”，利用高能量的放射線，通過精確定位，精確計劃和精確放療，殺滅腫瘤細(xì)胞，具有無痛、微創(chuàng)、不開刀、不出血的優(yōu)點(diǎn)，不僅對宮頸癌治療有效，對鼻咽癌、喉癌、下咽癌、食管癌、淋巴瘤、前列腺癌等腫瘤治療有效率也很高，尤其適用于患有各種慢性病，心肺功能不佳，手術(shù)耐受性差的中老年患者，通過個體化、規(guī)范化的精準(zhǔn)治療，讓患者獲得更高質(zhì)量的生存。http://www.jyry.com/Article/ShowArticle.asp?ArticleID=4894

【摘要】目的：研究紫杉醇聯(lián)合順鉑化療方案治療中晚期食管癌患者的臨床療效與價值，為臨床治療工作的順利開展提供有價值的參考依據(jù)。方法：隨機(jī)將2018年1月至2019年1月我院60例中晚期食管癌患者分為實(shí)驗(yàn)組（30例，應(yīng)用紫杉醇聯(lián)合順鉑化療方案治療）、對照組（30例，應(yīng)用氟尿嘧啶聯(lián)合順鉑治療）。對比兩組患者治療前后卡氏評分、生存質(zhì)量評分、臨床治療效果、平均生存時間。結(jié)果：治療前，實(shí)驗(yàn)組卡氏評分為（70.04±2.33）分、生存質(zhì)量評分為（61.27±3.86）分，對照組卡氏評分為（70.05±2.32）分、生存質(zhì)量評分為（61.25±3.85）分，組間差異不明顯，t值分別為0.0166、0.0200，p值分別為0.9868、0.9840，組間對比呈現(xiàn)為p>0.05。治療后，實(shí)驗(yàn)組卡氏評分為（79.65±4.03）分、生存質(zhì)量評分為（83.57±4.41）分，對照組卡氏評分為（71.32±2.44）分、生存質(zhì)量評分為（71.67±2.23）分，前者兩項(xiàng)指標(biāo)均高于后者，t值分別為9.6846、13.1894，p值分別為0.0000、0.0000，臨床對比存在統(tǒng)計學(xué)差異（p<0.05）；實(shí)驗(yàn)組臨床治療總有效率為96.67%（29/30），對照組臨床治療總有效率為70.00%（21/30），實(shí)驗(yàn)組遠(yuǎn)遠(yuǎn)高于對照組，X2=7.6800，P=0.0055，臨床比較差異性顯著（P<0.05）；實(shí)驗(yàn)組平均生存時間為（10.37±2.38）月，對照組平均生存時間為（6.15±1.65）月，后者短于前者，t=7.9812，p=0.0000，組間比較存在顯著差異性（P<0.05）。結(jié)論：臨床治療中晚期食管癌的過程中，應(yīng)用紫杉醇聯(lián)合順鉑化療方案，療效確切，且患者臨床癥狀明顯改善，可有效提高患者生存質(zhì)量，延長生存時間、毒性反應(yīng)少，值得推廣與應(yīng)用?！娟P(guān)鍵詞】紫杉醇；順鉑；化療方案；中晚期食管癌；臨床效果【Abstract】Objective: To study the clinical efficacy and value of paclitaxel combined with cisplatin chemotherapy in the treatment of patients with advanced esophageal cancer, and provide a valuable reference for the smooth development of clinical treatment. Methods: From January 2018 to January 2019, 60 patients with advanced esophageal cancer were randomly divided into experimental group (30 cases, treated with paclitaxel combined with cisplatin chemotherapy) and control group (30 cases with fluorouracil combined with cis Platinum treatment). The Carr's score, quality of life score, clinical treatment effect, mean survival time, and incidence of toxic reaction were compared before and after treatment. Results: Before treatment, the experimental group had a score of (70.04±2.33) and a quality of life score of (61.27±3.86). The control group had a score of (70.05±2.32) and a quality of life score of (61.25±3.85). ), the difference between the groups was not obvious, the t values were 0.0166 and 0.0200, respectively, and the p values were 0.9868 and 0.9840, respectively, and the comparison between groups was p>0.05. After treatment, the experimental group had a score of (79.65±4.03) and a quality of life score of (83.57±4.41). The control group had a score of (71.32±2.44) and a quality of life score of (71.67±2.23). The former two indicators were higher than the latter, t values were 9.6846, 13.19,894, respectively, p values were 0.0000, 0.0000, the clinical comparison was statistically significant (p<0.05); the experimental group total effective rate was 96.67% ( 29/30), the total effective rate of clinical treatment in the control group was 70.00% (21/30), the experimental group was much higher than the control group, X2=7.6800, P=0.0055, and the clinical comparison was significant (P<0.05); The average survival time of the group was (10.37±2.38) months, and the average survival time of the control group was (6.15±1.65) months. The latter was shorter than the former, t=7.9812, p=0.0000. There was significant difference between the groups (P<0.05). ).Conclusion: The clinical application of paclitaxel combined with cisplatin chemotherapy in the treatment of advanced esophageal cancer is effective, and the clinical symptoms of patients are significantly improved, which can effectively improve the quality of life, prolong the survival time and less toxicity. It is worthy of promotion and application.【Key words】 paclitaxel； cisplatin； chemotherapy regimen； advanced esophageal cancer； clinical effect

姜勇，腫瘤科主任醫(yī)師，碩士研究生，泰州市“311工程”培養(yǎng)對象，師從留美博士后、江蘇省腫瘤醫(yī)院黃新恩教授。第一作者身份，發(fā)表SCI論文2篇，中華雜志論文1篇，國家級核心期刊論文6篇。兩篇論文入選《江蘇省第四次腫瘤化療與生物治療學(xué)術(shù)會議論文集》；第一作者身份，獲泰州市自然科學(xué)優(yōu)秀論文一等獎1項(xiàng)，二等獎1項(xiàng)，三等獎3項(xiàng)。2013年晉升腫瘤科副主任醫(yī)師，2014年獲泰州市科技進(jìn)步二等獎1項(xiàng)，2015年江蘇省腫瘤醫(yī)院進(jìn)修頭頸、胸腹腫瘤精確放射治療、同步化療一年。2020年晉升主任醫(yī)師，臨床工作近20年，江蘇省腫瘤醫(yī)院研修放化療4年，腫瘤診治經(jīng)驗(yàn)豐富，深諳學(xué)科前沿進(jìn)展，擅長精確放療，全身化療，射頻消融，肝肺穿刺活檢，深靜脈置管，體腔灌注化療。目前主要基于惡性腫瘤臨床實(shí)踐指南，合理結(jié)合放療與化療，從事各類癌癥的臨床診斷和規(guī)范化、個體化、綜合化治療。 專家門診時間：每周五下午http://www.jyry.com/Article/ShowArticle.asp?ArticleID=2830