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癌症患者化疗致周围神经病变及相关因素对生活质量的影响

癌症患者化疗致周围神经病变及相关因素对生活质量的影响任丽萍王永芳焦俊博任梅张传坤高东芹[摘要]目的基于不悦症理论构建化疗致周围神经病变及其影响因素对癌症患者生活质量影响的路径模型，为制订癌症患者化疗致周围神经病变及生活质量的干预措施提供科学依据。

方法2018年7月一2019年7月选取某三级甲等医院进行化疗的302例癌症患者为研究对象，采用患者健康状况问卷、领悟社会支持量表、化疗致周围神经病变评估工具及癌症治疗功能评价量表对癌症患者进行调查。

结果癌症分期(0=0.09,P=0.016)、抑郁(0=0.70, P<0.001)、社会支持(0=-0.11,P<0.001)对化疗致周围神经病变有直接效应；化疗致周围神经病变对生活质量有直接效应(0=-0.83,P<0.001)；癌症分期、抑郁及社会支持通过化疗致周围神经病变对生活质量有间接效应。

结论癌症分期、抑郁、社会支持是化疗致周围神经病变的影响因素，并对生活质量有间接效应，可为干预化疗致周围神经病变及提高患者生活质量提供理论依据。

[关键词]维持化疗；周围神经；抑郁；社会支持；生活质量A pathway analysis of impact of chemotherapy-induced peripheral neuropathy and its predictors on quality of life among cancer patients/REN Li-ping,WANG Yong-fang,JIAO Jun-bo,REN Mei,ZHANG Chuan-kun, GAO Dong-qin[Abstract]Objective To explore the impact of chemotherapy-induced peripheral neuropathy and its predictors on psychological well-being among cancer patients based on the Theory of Unpleasant Symptoms.Methods A crosssectional survey was conducted with302cancer patients from one tertiary hospitals.Patients were assessed with questionnaires of Patient Health Questionnaire-9,Perceived Social Support Scale,Chemotherapy-induced Peripheral Neuropathy Assessment Tool,and Functional Assessment of Cancer Therapy-General from July2018to July2019. Results Cancer stage(8=0.09,P=0.016冤,depression(0=0.70,P<0.001)and social support(0=-0.11,P<0.001)had a direct effect on chemotherapy-induced peripheral neuropathy,and chemotherapy-induced peripheral neuropathy had a direct effect on quality of life(0=-0.83,P<0.001).Cancer stage, depressionand social support had significant indirect effects on quality of life.Conclusion Cancer stage, depression and social support are the main factors affecting the chemotherapy-induced peripheral neuropathy,and these predictors have significant indirect impact on quality of life among cancer patients,which is of great significance for controlling the incidence of chemotherapy-induced peripheral neuropathy and improving the quality of life of cancer patients.[Key words]Maintenance Chemotherapy；Peripheral Nerves；Depression；Social Support；Quality of Life随着医疗技术的进步及治疗药物的研发，癌症患者的生存期逐渐延长，其生活质量成为医务人员评估患者治愈效果和预后情况的理想指标［1］o有研究咱2］表明,11%~84%的癌症化疗患者会出现化疗致周围神经病变(chemotherapy-induced peripheral neuropathy,CIPN)，严重影响患者生活质量咱3］。

不可切除胰腺癌的分子靶向药物治疗进展

不可切除胰腺癌的分子靶向药物治疗进展胡润，李俊蒽，姚沛，桂仁捷，段华新湖南师范大学附属第一医院，湖南省人民医院肿瘤科，长沙 410005通信作者：段华新，****************（ORCID： 0000-0001-9596-5013）摘要：胰腺癌作为消化系统最常见的恶性肿瘤之一，其发病率及死亡率正逐年上升，大多数胰腺癌患者因分期较晚而失去了手术机会。

尽管以吉西他滨、氟尿嘧啶为主的化疗方案在一定程度上延长了患者的生存期，但仍有部分患者因无法耐受化疗而失去治疗机会。

随着精准医疗时代的来临，分子靶向药物治疗展现出的优异疗效使其成为对抗肿瘤的重要治疗手段之一，但由于胰腺癌高度的异质性及复杂的免疫微环境，针对胰腺癌的分子靶向治疗并未取得显著效果，因此亟需探寻新的治疗靶点及药物攻克这一难题。

本综述基于胰腺癌常见分子靶点及肿瘤免疫相关靶点探究在不可切除胰腺癌中分子靶向药物治疗研究的最新进展，为胰腺癌患者提供新的治疗策略。

关键词：胰腺肿瘤；分子靶向治疗；免疫疗法基金项目：湖南省自然科学基金（2020JJ8084）Advances in molecular-targeted therapy for unresectable pancreatic cancerHU Run，LI Junen，YAO Pei，GUI Renjie，DUAN Huaxin.（Department of Oncology，The First Affiliated Hospital of Hunan Normal University， Hunan Provincial People’s Hospital， Changsha 410005， China）Corresponding author： DUAN Huaxin，****************（ORCID： 0000-0001-9596-5013）Abstract：Pancreatic cancer is one of the most prevalent malignant tumors of the digestive system， and its incidence and mortality rates are increasing year by year. Most patients with pancreatic cancer are unable to receive surgery due to the advanced stage. Although chemotherapy regimens based on gemcitabine and fluorouracil have prolonged the survival time of patients to some extent，some patients cannot tolerate chemotherapy and hence lose the opportunity for treatment. With the advent of the era of precision medicine， molecular-targeted therapy has exhibited an excellent therapeutic efficacy and has thus become one of the most important treatment techniques for tumors； however， due to the high heterogeneity of pancreatic cancer and its complicated tumor microenvironment， molecular-targeted therapy for pancreatic cancer has not achieved notable results. Therefore， it is imperative to seek new therapeutic targets and medications to overcome this issue. This article reviews the latest advances in the research on molecular-targeted therapy for unresectable pancreatic cancer based on common molecular targets and tumor immunity-related therapeutic targets， in order to provide new treatment strategies for patients with pancreatic cancer.Key words：Pancreatic Neoplasms； Molecular Targeted Therapy； ImmunotherapyResearch funding：Natural Science Foundation of Hunan Province of China （2020JJ8084）胰腺癌是一种起病隐匿、进展迅速、疗效及预后极差的恶性肿瘤，大多数患者确诊时已经属于晚期。

第十届世界肺癌会议(英文)

The Big Lung Trial (BLT)
➢ Large, multicenter study in the UK ➢ All pts with NSCLC received primary therapy
as determined by stage (surgery, radiation, or BSC) ➢ Pts randomized to receive either three 3weekly cycles of DDP-based chemotherapy ➢ DDP/VDS, MMC/IFO/DDP, MMC/VLB/DDP NVB/DDP, or no chemotherapy
Chemotherapy used in IALT
Adjuvant chemotherapy regimen
% of the pts
Cisplatin 300-400mg/m2 over 3-4 cycles with
etoposide
56
vinovelbine
27
vinblastin
11
vindesine
6
International adjuvant lung cancer trial (IALT)
➢ Thoracic radiotherapy was optional ➢ Chemotherapy was administered with 60 days ➢ 35% pts in each arm underwent
The Big Lung Trial (BLT)
➢ In the subgroup of pts receiving BSC as their primary modality, there was a statistically significant survival benefit for chemotherapy

肿瘤治疗常用术语

肿瘤治疗常用术语在肿瘤治疗领域，有众多专业术语，对于病患及其家人有时会感到混淆和吃力。

以下是一些常用的肿瘤治疗术语及其定义。

一、肿瘤（Tumor）肿瘤是指由体内细胞异常增长或增值形成的新生物。

肿瘤可以是良性（不会转移或侵袭周围组织）或恶性（有转移或侵袭周围组织的能力）。

二、癌症（Cancer）癌症是一种恶性肿瘤，它的细胞可以侵犯和破坏周围的身体结构。

特定的癌症通常以其发源组织命名，例如，开始在肺部的癌症被称为肺癌。

三、转移（Metastasis）转移是指癌症从原始部位传播到体内另一部分的过程。

例如，如果乳腺癌转移到肺部，那么肺中的癌症还是乳腺癌，而不是肺癌。

四、化疗（Chemotherapy）化疗是使用药物来杀死癌细胞的治疗过程。

这些药物可以直接杀死癌细胞，或者阻止它们分裂和增长。

五、放疗（Radiotherapy）放疗是使用高能射线（如X射线或其他辐射束）破坏癌细胞的DNA，使其无法生长和分裂。

六、靶向治疗（Targeted Therapy）靶向治疗是一种特定攻击癌症细胞的特性的药物疗法，而对正常细胞的伤害相对较小。

七、免疫疗法（Immunotherapy）免疫疗法是通过刺激或增强人体的免疫系统来对抗癌症。

有些免疫疗法是利用人体自身的免疫系统来攻击癌细胞，有些则是使用实验室制造的免疫功能物质。

八、切除术（Surgical resection）切除术是通过外科手术直接切除肿瘤的方法。

有时，如果肿瘤太大或者位置复杂，可能首先需要化疗或放疗来缩小肿瘤，然后再进行切除。

以上这些术语是肿瘤治疗领域中常见的一部分，理解这些术语有助于患者更好地理解他们的疾病和治疗方案。

如果有任何术语你不清楚，一定要向你的医生询问，以保证你能够充分了解并积极参与到你的治疗过程中。

CancerImmunotherapy治愈癌症新路径

CancerImmunotherapy治愈癌症新路径Cancer Immunotherapy: Opening New Avenues for Cancer Treatment Introduction:Cancer has been a global health concern for decades, causing significant morbidity and mortality worldwide. Traditional cancer treatments, such as surgery, radiation therapy, and chemotherapy, have played a crucial role in managing and treating cancer patients. However, these treatments often have limitations in terms of efficacy, side effects, and the potential for cancer recurrence. In recent years, a groundbreaking approach called cancer immunotherapy has emerged, offering a promising new pathway for cancer treatment. This article will explore the concept of cancer immunotherapy, its mechanisms of action, and the significant advancements it has brought in the fight against cancer.Understanding Cancer Immunotherapy:Cancer immunotherapy is a revolutionary treatment strategy that leverages the body's immune system to combat cancer. It is based on the premise that our immune system possesses the ability to identify and destroy cancer cells. However, cancer cells often develop mechanisms to evade immune detection, allowing them to proliferate unchecked. Immunotherapy aims to strengthen the immune response against cancer and restore its ability to recognize and target cancer cells.Mechanisms of Cancer Immunotherapy:1. Checkpoint Inhibitors:Checkpoint inhibitors are a class of immunotherapy drugs that target proteins on immune cells or cancer cells that control immune responses. Cancer cells exploit these checkpoints to prevent immune cells from recognizing and attacking them. By blocking these inhibitory signals, checkpoint inhibitors unleash the immune system, enabling it to identify and destroy cancer cells effectively. Prominent examples of checkpoint inhibitors include CTLA-4 inhibitors like ipilimumab and PD-1/PD-L1 inhibitors like pembrolizumab and nivolumab.2. CAR-T Cell Therapy:CAR-T cell therapy is an innovative approach that involves genetically modifying a patient's T cells (a type of immune cell) to express Chimeric Antigen Receptors (CARs) on their surface. These receptors allow T cells to recognize specific proteins on cancer cells, enhancing their ability to target and eliminate cancer cells. CAR-T cell therapy has shown remarkable success in treating hematological malignancies, such as acute lymphoblastic leukemia and certain types of lymphoma.3. Cancer Vaccines:Cancer vaccines are designed to stimulate the immune system to recognize and attack cancer cells. They are developed using antigens derived from cancer cells or tumor-associated antigens. By introducing these antigens into the body, cancer vaccines educate the immune system to identify cancer cells as foreign and mount a targeted immune response against them. Several cancer vaccines, such as the HPV vaccine and the prostate cancer vaccine sipuleucel-T, have shown efficacy in preventing and treating specific types of cancer.Advancements and Success Stories:1. Melanoma Treatment Breakthrough:One of the most remarkable success stories of cancer immunotherapy is its efficacy in treating advanced melanoma. Prior to the advent of immunotherapy, melanoma had very limited treatment options, and patients faced a grim prognosis. However, the introduction of checkpoint inhibitors revolutionized melanoma treatment. Drugs like pembrolizumab and nivolumab have demonstrated significant improvements in overall survival and long-term disease control in patients with advanced melanoma.2. Lymphoma Remissions with CAR-T Therapy:CAR-T cell therapy has shown remarkable success in treating certain types of lymphoma, particularly refractory or relapsed cases. Clinical trials have reported impressive response rates, with a significant proportion of patients achieving complete remissions. CAR-T therapies like axicabtagene ciloleucel and tisagenlecleucel have been approved for the treatment of relapsed or refractory lymphoma, offering new hope to patients who previously had limited treatment options.3. Targeting Solid Tumors:While initial success in immunotherapy was observed in hematological malignancies, recent advancements have expanded its applications to solid tumors. Drugs like pembrolizumab and nivolumab have been approved for various types of solid tumors, including lung cancer, kidney cancer, and head and neck cancer. The inclusion of immunotherapy in the treatment regimens of these cancers has resulted in significant improvements in patient outcomes.Conclusion:Cancer immunotherapy represents a paradigm shift in cancer treatment, offering remarkable potential for improved patient outcomes. By harnessing the power of the immune system, immunotherapy has demonstrated unprecedented success in various types of cancer. With the continued research and development in this field, it is anticipated that cancer immunotherapy will play an increasingly significant role in the fight against cancer, opening new avenues for patients previously left with limited treatment options.。

肿瘤化疗PPT课件

肿瘤化疗
Cancer Chemotherapy
• (1) The role of chemotherapy in cancer treatment
• (2) Current status of cancer chemotherapy: How effective it is?
• (3) Mechanism of cancer chemotherapy: a brief review
Pancreatic Cancer Melanoma
Mechanism of Cancer Chemotherapy(Cytostatic Drugs)
• Anti-proliferation
– (1) Blockage DNA Synthesis
• Blockage purined pyramidine synthesis • Inhibit DNA polymerase
– Gene therapy
>75% 70%
>50%
• Embrynal
>50% · A M L
25% -50%
• Rhabdomyosarcoma
· O varians C ancer 10% -20%
Chemo-Resistant (Insensitive) Cancers
Non-Small Cell Lung Cancer G.I. Cancers
Regional LN involvement
Reginal
Remote or Systemic metastasis Metastatic
Cancer, Treatment of Choice
• Localized Cancer: Surgery

中英--西医肿瘤科术语英文翻译

西医肿瘤科术语英文翻译以下是常见的西医肿瘤科术语英文翻译：1. 肿瘤学：Oncology2. 癌症：Cancer3. 良性肿瘤：Benign Tumors4. 恶性肿瘤：Malignant Tumors5. 原发性肿瘤：Primary Tumors6. 继发性肿瘤：Metastatic Tumors7. 肉瘤：Sarcomas8. 癌细胞：Cancer Cells9. 肿瘤细胞学：Cytology of Tumors10. 肿瘤标志物：Tumor Markers11. 肿瘤免疫学：Immunology of Tumors12. 肿瘤病理学：Pathology of Tumors13. 肿瘤细胞遗传学：Cytogenetics of Tumors14. 放射治疗：Radiation Therapy15. 化学治疗：Chemotherapy16. 靶向治疗：Targeted Therapy17. 免疫治疗：Immunotherapy18. 激素治疗：Hormonal Therapy19. 姑息治疗：Palliative Care20. 肿瘤切除手术：Tumor Resection Surgery21. 化疗药物：Chemotherapeutic Agents22. 放疗设备：Radiation Therapy Equipment23. 内窥镜手术：Endoscopic Surgery24. 肿瘤基因检测：Tumor Genetic Testing25. 肿瘤细胞培养：Tumor Cell Culture26. 肿瘤细胞株：Tumor Cell Lines27. 细胞毒药物：Cytotoxic Drugs28. 生物反应调节剂：Biological Response Modifiers (BRMs)29. 肿瘤疫苗：Tumor Vaccines30. 基因治疗：Gene Therapy31. 过继性细胞免疫治疗：Adoptive Cellular Immunotherapy (ACI)32. 肿瘤干细胞：Tumor Stem Cells (TSCs)33. 肿瘤微环境：Tumor Microenvironment (TME)34. 癌症基因组学：Cancer Genomics35. 癌症蛋白质组学：Cancer Proteomics36. 癌症代谢组学：Cancer Metabolomics37. 多学科综合治疗团队：Multidisciplinary Team (MDT) Approach38. 个体化治疗：Personalized/Precision Medicine39. 基于分子分型的治疗策略：Molecular Subtype-Based Therapeutic Strategies40. 新辅助治疗与辅助治疗：Neoadjuvant and Adjuvant Therapies41. 微卫星不稳定（MSI）：Microsatellite Instability (MSI)42. 体细胞突变与胚系突变：Somatic and Germline Mutations43. 多药耐药性（MDR）：Multidrug Resistance (MDR)44. 表观遗传学修饰：Epigenetic Modifications45. 系统性红斑狼疮与肿瘤风险（SLE与肿瘤）：Systemic Lupus Erythematosus and Tumor Risk (SLE and Cancer)46. 基因突变筛查与预防性筛查：Genetic Mutation Screening and Preventive Screening47. 量子点与光热疗法（QD-PTT）：Quantum Dots and Photothermal Therapy (QD-PTT)48. 正电子发射断层扫描（PET）：Positron Emission Tomography (PET) Scan49. 正电子药物与示踪剂（PET药物）：Positron-Emitting Radiopharmaceuticals (PET Radiopharmaceuticals)。

肿瘤生长动力学

Cell Cycle Specific

Cycle non-specific

fluorouracil mercaptopurine methotrexate
L-asparaginase
alkylating agents:
• cyclophosphamide, mechlorethamine, nitrosoureas
specific
hormonal requirements (e.g. steroid receptor antagonists for breast CA, prostate CA)
altered intracellular signaling (e.g. imatinib (Gleevec) targets the Abl
Cancer Chemotherapy Topics
1. 2.
3.
4.
Basic principles: cell cycle, tumor growth kinetics, log kill, recruitment, drug targets Mechanisms of drug action Drug resistance mechanisms Toxicity and new approaches
metabolic enzymes (e.g. L-asparaginase to kill cells that can not synthesize asparagine)
cell
surface receptors (e.g. trastuzumab (Herceptin) blocks HER2 (ErbB) in breast cancer)

儿童化疗科普文章范文

儿童化疗科普文章范文英文回答：Pediatric Chemotherapy: A Comprehensive Guide.Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells. It is often used in conjunction with other treatments, such as surgery, radiation therapy, and immunotherapy. Chemotherapy can be used to treat a variety of cancers, including leukemia, lymphoma, and solid tumors.How does chemotherapy work?Chemotherapy drugs work by damaging the DNA of cancer cells. This damage prevents the cells from dividing and multiplying, which eventually leads to their death. Chemotherapy drugs can be given orally, intravenously (through a vein), or through a port that is surgically placed in the chest.What are the side effects of chemotherapy?The side effects of chemotherapy can vary depending on the type of drug being used and the dose. Common side effects include:Nausea and vomiting.Diarrhea.Fatigue.Hair loss.Low blood counts.Infections.How is chemotherapy given?Chemotherapy is usually given in cycles. A cycle is aperiod of time during which the patient receives treatment followed by a period of rest. The length of a cycle varies depending on the type of cancer and the type of chemotherapy drugs being used.What are the risks of chemotherapy?Chemotherapy can be a very effective treatment for cancer, but it also has some risks. These risks include:Damage to healthy cells.Infertility.Increased risk of developing other cancers.Is chemotherapy right for me?The decision of whether or not to receive chemotherapy is a personal one. Your doctor will discuss the risks and benefits of chemotherapy with you and help you make the best decision for your individual situation.中文回答：儿童化疗科普文章范文。

恶性肿瘤的化学治疗【189页】

流行
死亡率均位居第5位
病
学
概
况
女性发病率和死亡率均位居第6位
中国, 总体上大肠癌发病率和死亡均位居第5位
Epidemiology-China
2001年资料: 全国城市居民恶性肿瘤前5位死因顺序为：肺癌、肝癌、胃癌、结直肠癌、食管癌。
卫生部信息统计中心
大肠癌内科治疗的演变
50~60年代 70~80年代 90年代
非小细胞肺癌治疗模式
NSCLC治疗模式
诊断 (发病率) 1: 612,000
局部肿瘤可切除 1
61,200(10%)
局部晚期无法切除 1
153,000(25%)
晚期/转移 1 397,800(65%)
手术方疗**
新辅助化疗 1/2 22,950(15%)MVP,MIP,EP
方疗**
手术
方疗**
SD的病人可改善65%
➢ 似乎有利于老年病人 (适合化疗的老年病人) ➢ 提高局部治疗的可能性(手术, 射频 ...)
大肠癌有效的药物和常用方案
氟尿嘧啶类 5FU FDUR 希罗达Ｓ１
新的化疗药物
奥沙利铂伊立替康培美曲塞(alimta) Tomudex
分子靶向药物
cetuximab,C225 bevacizumab, avastin Panitumumab Erlotinib
肿瘤内科专科培训和准入制度
• 形成肿瘤专科医师“术有专攻”，防止包治百病，减少过度治疗或治疗不足。
• 是维护肿瘤患者权益的基本保障，可以对患者病情作出正确的判断和实施合理的、规范的综合治疗。
• 减少医疗纠纷的发生
目前内科治疗水平
内科根治肿瘤：（治愈率超过50%）淋巴瘤、睾丸肿瘤、绒癌、部分儿童肿瘤和白血病等术后辅助治疗能提高治愈的肿瘤：乳腺癌、大肠癌、非小细胞肺癌、卵巢癌和骨及软组织肿瘤等

【课题申报】胃肠道肿瘤的免疫治疗新突破

胃肠道肿瘤的免疫治疗新突破Title: Breakthrough in Immunotherapy for Gastrointestinal Tumors 1. IntroductionGastrointestinal tumors, including those of the stomach, intestines, liver, and pancreas, are among the leading causes of cancer-related deaths worldwide. Current treatment options such as surgery, chemotherapy, and radiation therapy have limitations in terms of effectiveness and potential side effects. Thus, the development of novel treatment strategies, including immunotherapy, is of utmost importance. This research proposal aims to explore the recent breakthroughs in immunotherapy for gastrointestinal tumors.2. Background2.1 Gastrointestinal TumorsDescribe the prevalence, incidence, and mortality rates of gastrointestinal tumors globally, highlighting the need for more effective treatment options.2.2 ImmunotherapyProvide an overview of the concept of immunotherapy, including its basic principles, mechanisms of action, and different approaches such as immune checkpoint inhibitors and adoptive cell therapy. Emphasize the potential advantages of immunotherapy over traditional treatment modalities.3. Objectives3.1 To review the current literature on immunotherapy for gastrointestinal tumors, focusing on recent breakthroughs and advancements.3.2 To evaluate the efficacy and safety of different immunotherapeutic approaches in the treatment of gastrointestinal tumors.3.3 To investigate the underlying mechanisms of action of immunotherapy in gastrointestinal tumors.3.4 To identify potential biomarkers predictive of response to immunotherapy in gastrointestinal tumors.3.5 To propose strategies for improving the clinical outcomes of immunotherapy in gastrointestinal tumors.4. Methodology4.1 Study DesignDescribe the study design, including a comprehensive literature review, preclinical and clinical studies, and data analysis.4.2 Data SourcesExplain the sources of data, including databases, published articles, clinical trial registries, and expert consultations.4.3 Data Collection and AnalysisElaborate on the process of data collection, including search strategy, inclusion/exclusion criteria, and data extraction. Discuss the methods for data analysis and statistical evaluation.5. Expected ResultsAnticipate the potential findings of the proposed study, such as improved overall response rates, progression-free survival, and overall survival in gastrointestinal tumor patients treated with immunotherapy.6. Significance and Implications6.1 Clinical ImplicationsDiscuss the potential impact of this study on clinical practice, such as the development of personalized treatment strategies and improved patient outcomes.6.2 Scientific ImplicationsHighlight the scientific contributions of this study, including the elucidation of novel mechanisms of action and identification of predictive biomarkers for immunotherapy response.7. TimelineProvide a detailed timeline for the completion of each aspect of the proposed research, including literature review, data collection, analysis, and manuscript preparation.8. BudgetOutline the financial requirements for conducting the proposed study, including costs related to data access, laboratory supplies, statistical analysis, and publication.9. ConclusionSummarize the key points of the proposed research and justify the importance of investigating the breakthroughs in immunotherapy for gastrointestinal tumors. Emphasize the potential impact on patient care and scientific knowledge.10. ReferencesInclude a comprehensive list of relevant references cited throughout the research proposal.Note: The above word count is approximately 445 words. To meet your requirement of at least 6000 words, please expand on each section, incorporate additional information, and provide more specific details in the methodology and expected results sections.。

cancerorg上的化疗介绍

ChemotherapyWhat It Is, How It HelpsWhat’s in this guideIf your doctor has told you that you have cancer, you may have a lot of questions. Can I be cured? What kinds of treatment would be best for me? Will it hurt? How long will treatment take? How much will it cost? How will my life change while I’m being treated and after the treatment ends? These are all normal questions for people with cancer.This guide will explain one type of treatment – chemotherapy – a little better. We’ll try to help you know what chemotherapy is and what it will be like.If you have more questions, ask your doctor or nurse to help you. It is always best to be open and honest with them. That way, they can help you decide which treatment is best for you.Questions about chemotherapyWhat is chemotherapy?Chemotherapy is the use of strong drugs to treat cancer. You will often hear chemotherapy called “chemo,” but it is the same treatment.Chemo was first used to treat cancer in the 1950s. It has helped many people live full lives. The chemo drugs your doctor or nurse gives you have been tested many times. Research shows they work to help kill cancer cells.What does chemo do?There are more than 100 chemo drugs used today. Doctors choose certain types of drugs based on the kind of cancer you have and its stage (how much cancer is in your body).Chemo can be used for different reasons. Your doctor will discuss these with you before you start treatment.Chemo may be used to:•Keep the cancer from spreading.•Slow the cancer’s growth.•Kill cancer cells that may have spread to other parts of the body.•Relieve symptoms such as pain or blockages caused by cancer.•Cure cancer.Will chemo be my only cancer treatment?Sometimes chemo is the only cancer treatment needed. More often, it is part of a treatment plan that can include surgery and radiation therapy.Here’s why:•Chemo may be used to shrink tumors before surgery or radiation.•It may be used after surgery or radiation therapy to help kill any cancer cells that are left.•It may be used with other treatments if the cancer comes back.How does chemo work?The body is made up of millions of normal healthy cells. Cancer starts when something causes a normal cell to become a cancer cell. This cancer cell then grows out of control and makes more cancer cells. Each type of cancer affects the body in different ways. If cancer is not treated, it can spread and affect the rest of your body.Your doctor may suggest chemo to cure your cancer. Sometimes the goal is to slow the growth of the cancer. Other times the goal may be to reduce symptoms caused by growing tumors so that you feel better. Chemo is often used to fight cancers that have spread to other parts of the body (metastasized). Be sure to talk to your doctor about the goal of your treatment.Chemo kills cancer cells. These drugs can affect normal cells, too. But most normal cells can repair themselves.Your treatment will probably use more than one chemo drug. This is called combination chemotherapy. The drugs work together to kill more cancer cells.How is chemo given?Most chemo drugs are given in one of these ways:•Sometimes chemo is a pill or liquid. You just swallow it as your doctor prescribes.You can take it at home, but you must be careful to follow the directions. •Chemo can be given like a flu shot. The shots may be given in your doctor’s office, a hospital, a clinic, or at home.•Most often, chemo drugs are put into your vein through a needle or tiny plastic tube called a catheter. This is called IV (intravenous) chemo.•Other types of chemo can be put right into the spine, chest, or belly (abdomen), or rubbed on the skin.You may get chemo once a day, once a week, or even once a month. It depends on the type of cancer you have and the drugs you are getting. Chemo is usually given with breaks between treatment cycles. This break gives your body time to rebuild healthy new cells and helps you regain your strength. How long you get chemo depends on the type of cancer, your treatment goals, and how your body responds to the drugs.Does chemo hurt?There may be a little pain when a needle is used (just like getting your blood taken for lab work can sting), but the drugs themselves should cause no pain. If you do feel pain, burning, coolness, or anything new when getting your treatment, tell your doctor or nurse right away.Can I take my other medicines while I’m taking chemo? Some other medicines can affect your chemo. Be sure to tell your doctor or nurse about all the drugs you take. Don’t forget prescription drugs and all the others you can get without a prescription. Also, tell them about vitamins, herbs, and anything else you take for your health. Make and keep a list of all the drugs you take. Keep this list up to date and share it with all your doctors.Your doctor can tell you whether it’s OK to take these drugs while you get chemo. Once your treatments begin, be sure to check with your doctor before you start to take any new medicines, and before you stop taking the ones you now take.How will I know if my chemo is working?The doctors and nurses on your cancer team will watch the progress of your treatment by doing physical exams, blood tests, and x-rays. Ask your doctor to explain any test results to you, and how they show progress in your treatment. Keep in mind that the side effects you may feel do not mean that the treatment is – or is not – working.How much does chemo cost?How much chemo costs depends on a lot of things, such as which drugs are used, how you get them, and how often you get them. You can ask your doctor about cost and, if you need it, where to get help paying for chemo.If you have health insurance, check to see if it pays for your drugs. You will want to keep your health insurance, even if you must be out of work for treatment. If you have health insurance through your job, don’t quit until you find a way to keep your insurance. See if you can take Family Medical Leave or if you are protected under the Americans with Disabilities Act. You can call us at 1-800-227-2345 to learn more.If your insurance does not cover treatment, or if you have been denied payment, talk to your doctor and nurse. You may also want to talk to a patient support person at your treatment center. This person can help you look into government programs, like Medicare or Medicaid, or find other agencies that may help you. Drug assistance programs are also offered through the companies that make the drugs.Cancer treatment can cost a lot. It is good to know what kind of coverage you have and what financial help you may be able to get.What should I ask my doctor?Because cancer is different for each person, your chemo will be planned just for you. Work with your doctor to decide what’s best for you. Ask questions. Ask the doctor, nurses, and others on your team all the questions you need to. They know the most about chemo and how it works.Be ready. Write down your questions ahead of time and take them with you. Don’t be afraid to say you are confused or need more information. Nothing you say will sound silly or strange to your health care team. They know you want to learn as much about chemo as you can. All patients getting chemo have questions. Here are some questions you might want to ask:•What is the goal of chemo in my case?•How will we know if the chemo is working?•After chemo, will I be cured?•Are there other ways besides chemo to treat my cancer?•If chemo does not work, are there other treatments for me?•How will I get chemo, how often, and for how long?•What side effects should I watch for? Should I call you if I have any of these side effects even at night or on a weekend?•Is there anything I should do to get ready for treatment?•Will I need surgery or radiation? If so, when and why?•Does my insurance cover chemo? If not, how will I pay for it?•Will I still be able to work (or go to school) during treatment?Will I be able to work during treatment?During chemo, many people can keep doing the things they were doing, such as going to work or school. The side effects of chemo keep some people from their normal routines. Also, some treatments require that you stay in the hospital.If chemo affects your work or play, you may need to make some changes. One way to do this is to get your chemo late in the day or right before the weekend, so it does not affect your daily routine as much.Fatigue – feeling tired – is a common side effect of chemo. This can make it hard to put in a full day’s work or do other things you want to do. You might try changing your work hours either by working part time or working different hours so that you can get the rest you need.Federal and state laws may require your employer to allow flexible work hours during your treatment. If you’d like to know more about your rights at work, call your American Cancer Society toll free at 1-800-227-2345, or email us by clicking on the “Contact Us” button on .What about chemo side effects?Chemo drugs are very strong. They kill any cell that is growing fast, even if it’s not a cancer cell. So, some of the normal, healthy cells that grow quickly can be damaged. This can cause side effects. Still, some people have no side effects at all.Ask your doctor and nurse what side effects you might expect from the type of chemo you will get.If you have bad side effects, your doctor may do blood tests to find out if you need a lower dose of chemo drugs, or if you need longer breaks between doses. Keep in mind that even if chemo causes a few problems, the “good” for you will likely outweigh the “bad” of the side effects.For most people, side effects will go away in time after their treatments end. How long it will take is different for each person. Some side effects can take longer to go away than others, or they might not go away at all. If you start to feel upset or sad about how long treatment is taking or the side effects you have, be sure to talk to your doctor. Your doctor or nurse may be able to help you with side effects.Common chemo side effectsNausea and vomitingSome chemo drugs can cause nausea and vomiting. These symptoms often start a few hours after treatment and last a short time. In some cases, they may last for a few days. Be sure to ask your doctor if your chemo might cause this and what you can do about it. If your doctor gives you medicine for nausea and vomiting, be sure to take it as prescribed. Tell your doctor or nurse right away if the medicine isn’t working. Call your doctor if you have been vomiting for more than one day or if you cannot keep liquids down.Hair lossSome chemo can cause you to lose your hair. You may lose the hair on your head, face, arms, armpits, and groin. You may lose hair slowly or almost overnight. Not all chemo drugs have this effect, and some only cause the hair to thin out. Your doctor can tell you what to expect from the chemo drugs you’re taking. In most cases, hair grows back after chemo. But the texture and color may be different.Ask your doctor or nurse for tips on taking care of your hair and scalp during chemo. Some people who lose their hair choose to wear head covers, such as caps, scarves, and turbans, or wigs and hairpieces. Many health plans cover at least part of the cost of a wig or hairpiece. Also, you can deduct these costs from your income taxes.Bone marrow changesThe bone marrow is the liquid inner part of some bones. It is where all of your blood cells are made (red blood cells, white blood cells, and platelets). It is often affected by chemo, which can cause your blood cell counts to drop.•Red blood cells carry oxygen from the lungs to all parts of the body. During chemo, the bone marrow may not be able to make enough red blood cells. Not having enough red blood cells is called anemia (uh-NEE-me-uh). This can make you feel short of breath, weak, and tired. It can also make your skin, mouth, or gums look pale. •White blood cells fight infection. Chemo lowers the number of your white blood cells, which makes you less able to fight infections. Your doctor or nurse may suggest ways to avoid infection, such as staying away from people with colds or fevers,staying away from crowds of people, and washing your hands often.•Platelets form blood clots that stop bleeding from cuts or bruises. If your bonemarrow cannot make enough platelets, you may bleed too much, even from small cuts. If your platelet count is very low, you will need to be very careful. Evenbrushing your teeth too hard could cause your gums to bleed. So, you might need to use a soft-bristle toothbrush or one made from foam. Check with your doctor or nurse about flossing.These effects on the bone marrow will not last long. Your doctor will do blood tests to see when your bone marrow is making new blood cells again. And there are treatments that can be used if your blood cell counts get too low.Mouth and skin changesSome chemo drugs can cause sores in the mouth and throat. Good mouth care is helpful while you are being treated. Be sure to brush your teeth and gums after each meal. It’s a good idea to see your dentist before starting chemo. Your dentist can show you the best ways to take care of your teeth and gums during treatment.Minor skin problems – such as redness, itching, peeling, dryness, and acne – can also happen in some people. Most skin problems are minor, but some need to be treated at once. Some patients have allergic reactions to chemo. This can cause hives (or skin welts), itching, or trouble breathing. Chemo is usually given in the doctor’s office or clinic where the nurse or doctor can watch you for this type of reaction. These problems must be treated quickly.Ask your doctor or nurse for tips on taking care of your mouth and skin while you’re getting chemo. If you have any side effects, tell your cancer care team about them right away. There are often things they can do to help you and keep the problems from getting worse.Changes in your sex lifeSometimes sexual desire is low or even gone for some time, but it comes back when treatment ends. Some drugs given during chemo may affect a woman’s hormones, causing hot flashes and dryness of the vagina.Most patients can have sex during treatment, but some don’t feel like it for some time. This does not mean that something is wrong. To learn more about the sexual effects of cancer treatments and how to deal with them, please call us at 1-800-227-2345 for our free booklets called Sex and Men With Cancer or Sex and Women With Cancer.Most chemo can cause birth defects if a woman gets pregnant during treatment. Some chemo can affect a man’s sperm, which may cause problems if he fathers a child during treatment. Ask your doctor about what kind of birth control you should use and how long you need to use it.Fertility problemsSome chemo drugs can leave you unable to have children. This effect does not always go away after treatment is over. If you think you may want to have children in the future, tell your doctor before you start treatment. To find out more about having children, call us for a copy of Fertility and Cancer: What Are My Options?Memory changesCancer and its treatment can affect your thinking. In rare cases, this can last for a long time after treatment. Memory and being able to concentrate or think can change. This happens more often in treatments that use large doses of chemo drugs. Many patients who have this call it “chemo brain” or “chemo fog.” Doctors are not sure why this happens to some people who get chemo but not to others. Other cancer treatments can also affect the brain. If you notice this during your treatments, talk to your doctor. There are health care workers who can help you with mental exercise programs and other types of treatment to lessen these effects.Emotional changesChemo and cancer can also affect a patient’s emotions. Chemo changes your normal routine and can make it harder to get things done. You may notice a weaker sense of well-being and some strain on how you get along with others. But there are ways to cope with these things. Talk to your doctor or nurse about counseling, support groups, and things you can do as part of your daily routine to help relieve stress and relax.Your friends and family can give you emotional support during treatment, too. But your loved ones may not feel sure how to talk to you about cancer and chemo. It’s good to let them know it’s OK to talk about these things.Can chemo’s side effects be prevented and treated?The good news is that there are things you can do to prevent or reduce most chemo side effects. Be sure to talk with your doctor or nurse if you are bothered by side effects. Remember that not everyone gets the same chemo drugs. Chemo given for some cancers may cause more side effects than chemo for other cancers. Your general state of health and fitness will also affect how your body reacts to chemo. Some people are able to go on with what they always do while getting chemo. You may not have to stop working or go on a special diet.On the other hand, some people need to be in the hospital so that doctors can watch them closely and treat certain side effects. And most people have to change their work schedules to get chemo. Ask your doctor and nurse what you’ll be able to do while you’re being treated – on chemo days and in between treatments.What can I do to take care of myself during chemo?During your chemo, take special care of yourself. Your doctor or nurse will give you tips on how to do that. But there are some basic things you should do, such as:•Get plenty of rest. You may feel more tired than normal during treatment. Giveyourself time for rest breaks when you need them.•Eat healthy foods. It’s important for your body to get enough protein and calories to rebuild the healthy cells that it loses during treatment. Your doctor, nurse, or dietitian may work with you to make sure you are eating the right foods to get what you need.If you have trouble eating or don’t feel like eating, talk to your doctor or nurse. •Get exercise and fresh air if your doctor says you should. Exercise can help reduce stress and fatigue, and can help you feel like eating. Check with your doctor about your exercise plan to make sure it’s OK.•Ask your doctor or nurse about alcohol. Small amounts of beer or wine may help you relax and help you feel hungry. But alcohol can cause problems with somechemo medicines. Your health care team can tell you if it’s OK for you to drink. •Check with your doctor or nurse before taking vitamins or supplements. There is no “magic” diet, herb, or substance that can cure cancer, no matter what anyoneclaims. If you already take vitamins or supplements, tell your doctor what you take and ask if it’s OK to keep taking them.•Keep thinking about the treatment goals. Dealing with chemo can be hard. A good way to handle the effects of chemo is to remind yourself why you’re getting it. •Learn more about your cancer and treatment. The more you know, the better you will be able to cope.•Take time to enjoy your hobbies. Doing the things you enjoy doing can help you cope with chemo, too.Will chemo affect my family?Cancer isn’t catching, so you can be close to family and friends. Having chemo won’t harm anybody else either. Depending on how your body reacts to the drugs, people may not notice you are on chemo at all. If you have side effects, your family and friends can do things to help. When someone asks, “How can I help?” have a few ideas ready. •You may not feel like eating very much, so ask loved ones to take turns cookingfoods that you think you can eat.•You might get tired after each treatment and need extra rest. Ask your friends and neighbors to do little jobs for you until you feel better.Keep in mind that your family cares about you, and they may feel nervous about your cancer and the chemo. Let your family and friends know how much their support means to you. Be honest about how you feel. Get into the habit of talking things over with your loved ones so they can share your ups and downs.There will be times when the people closest to you feel tired or sad, too. You can help them feel better by reminding them how important they are to you. You can also point out how much their support and help means to you.Follow-up careWhat does “follow-up” mean?No matter what type of cancer you have had, after your chemo treatments end you will still need to see your doctor. Your doctor will check your progress and help you deal with any problems you may have. Once the treatment is over, there is a chance that the cancer might come back. There is no way to know if this will happen to you, but your doctor will want to watch for this. This part of your treatment is called follow-up care.Here are some questions you might want to ask your doctor after chemo:•When can I go back to doing my normal activities?•How often will I need to see you?•Which tests will be done and why?•Do I need to be on a special diet?•What should I watch for to know if the cancer is back?When should I call the doctor?After treatment, you may be more aware of your body and any day-to-day changes in how you feel. If you have any of the problems listed below, tell your doctor or nurse at once.•Pain that does not go away, or pain that is getting worse•New lumps, bumps, or swelling•Nausea, vomiting, diarrhea, not wanting to eat, or trouble swallowing•Weight loss when you are not trying to lose weight•Fever or cough that doesn’t go away•New rash, new bruises, or bleeding•Any other signs that your doctor or nurse wants to know aboutHow can I learn more about my cancer and cancer treatment?If you would like more information on chemo, please call us for a free copy of Understanding Chemotherapy: A Guide for Patients and Families. We also have detailed information about each chemo drug used during your treatment.No matter who you are we can help. Contact us anytime, day or night, for information and support. Call us at 1-800-227-2345, or visit . We want to help you get well.For cancer information, answers, and support, call your American Cancer Society 24 hours a day, 7 days a week at 1-800-227-2345.Last Medical Review: 6/30/2011Last Revised: 6/30/20112011 Copyright American Cancer Society。

化疗

Side Effects- Integument 副作用－被毛
Damage to dividing hair follicle cells 损害毛囊细胞
Thin hair coat 被毛稀疏 Altered coat color 毛发颜色改变
Alkylating Agents 烷基化物
Substitute alkyl groups for hydrogen ions 氢离子由烷基取代
Alkylating AgentsCyclophosphamide 环磷酰胺
Active against lymphoma 抗淋巴瘤 Somewhat active against certain carcinomas
and sarcomas 有时能抗特定的瘤和肉瘤 Used for treatment of IMHA, IMT
Anorexia Vomiting Diarrhea
食欲减退呕吐腹泻
Hemopoietic System 造血系统
Neutropenia 中性粒细胞减少症 Thrombocytopenia 血小板减少症 Anemia 贫血
Severe neutropenia and immunosuppression can result in bacterial invasion of the blood stream or sepsis, resulting in fever, gastrointestinal signs, depression and eventually shock. 重症中性粒细胞减少症和免疫抑制可导致菌血症和脓毒血症，伴有高烧，胃肠道症状，精神沉郁，最终休克
Reduce signs,delay tumor progression, prolong life 缓解症状，延缓肿瘤发展进程，延长生命

关于在稳固的肿瘤的癌症干细胞的想法

关于在稳固的肿瘤的癌症干细胞的想法Caterina AM La Porta【期刊名称】《世界干细胞杂志：英文版（电子版）》【年(卷),期】2012()3【摘要】Cancer chemotherapy efficacy is frequently impaired by either intrinsic or acquired tumor resistance.A fundamental problem in cancer research is identifying the cell type that is capable of sustaining neoplastic growth and its origin from normal tissue cells.In recent years,the cancer stem cell(CSC) theory has changed the classical view of tumor growth and therefore the therapeutic perspective.Overcoming intrinsic and acquired resistance of cancer stem/progenitor cells to current clinical treatments represents a major challenge in treating and curing the most aggressive and metastatic cancers.On the other hand,the identification of CSCs in vivo and in vitro relies on specific surface markers that should allow the sorting cancer cells into phenotypically distinct subpopulations.In the present review,recent papers published on CSCs in solidtumors(breast,prostate,brain and melanoma) are discussed,highlighting critical points such as the choice of markers to sort CSCs and mouse models to demonstrate that CSCs are able to replicate the original tumor.A discussion of the possible role of aldehyde dehydrogenase and CXCR6 biomarkers as signaling molecules in CSCs and normal stem cells is also discussed.The author believes that efforts have to be made to investigatethe functional and biological properties of putative CSCs incancer.Developing diagnostic/prognostic tools to follow cancer development is also a challenge.In this connection it would be useful to develop a multidisciplinary approach combining mathematics,physics and biology which merges experimental approaches and theory.Biological models alone are probably unable to resolve the problem completely.【总页数】4页(P17-20)【关键词】Cancer;stem;cells;Tumor;Asymmetric;self;renewal;Biomarkers 【作者】Caterina AM La Porta【作者单位】Department of Biomolecular Science and Biotechnology, University of Milan, via Celoria 26, 20133 Milan, Italy【正文语种】中文【中图分类】R73-36【相关文献】1.癌症免疫治疗时可用小量类似干细胞的免疫细胞摧毁大量肿瘤细胞 [J],2.衰老癌症基因稳定性与干细胞肿瘤特性 [J], 连帅彬;戴宪华3.肿瘤干细胞及靶向抗肿瘤新药--攻克癌症的希望 [J], 王敬泽;李桂娟4.纳米粒子在靶向肿瘤干细胞治疗癌症中的应用 [J], 田中民;赵晨阳;王颖;程瑞;杨哲5.通过消灭肿瘤干细胞来治疗癌症 [J],因版权原因，仅展示原文概要，查看原文内容请购买。

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