常見實(shí)體瘤化療方課件講義

常見實(shí)體瘤化療方1、不要輕言放棄，否則對(duì)不起自己。2、要冒一次險(xiǎn)!整個(gè)生命就是一場(chǎng)冒險(xiǎn)。走得最遠(yuǎn)的人，常是愿意去做，并愿意去冒險(xiǎn)的人?！胺€(wěn)妥”之船，從未能從岸邊走遠(yuǎn)。--戴爾．卡耐基。3、人生就像一杯沒有加糖的咖啡，喝起來是苦澀的，回味起來卻有久久不會(huì)退去的余香。4、守業(yè)的最好辦法就是不斷的發(fā)展。5、當(dāng)愛不能完美，我寧愿選擇無悔，不管來生多么美麗，我不愿失去今生對(duì)你的記憶，我不求天長地久的美景，我只要生生世世的輪回里有你。常見實(shí)體瘤化療方常見實(shí)體瘤化療方1、不要輕言放棄，否則對(duì)不起自己。2、要冒一次險(xiǎn)!整個(gè)生命就是一場(chǎng)冒險(xiǎn)。走得最遠(yuǎn)的人，常是愿意去做，并愿意去冒險(xiǎn)的人?！胺€(wěn)妥”之船，從未能從岸邊走遠(yuǎn)。--戴爾．卡耐基。3、人生就像一杯沒有加糖的咖啡，喝起來是苦澀的，回味起來卻有久久不會(huì)退去的余香。4、守業(yè)的最好辦法就是不斷的發(fā)展。5、當(dāng)愛不能完美，我寧愿選擇無悔，不管來生多么美麗，我不愿失去今生對(duì)你的記憶，我不求天長地久的美景，我只要生生世世的輪回里有你。常見實(shí)體瘤化療方案選擇湖南省腫瘤醫(yī)院羅以主要內(nèi)容非小細(xì)胞肺癌大腸癌■乳腺癌■惡性淋巴瘤常見實(shí)體瘤化療方1、不要輕言放棄，否則對(duì)不起自己。常見實(shí)體瘤1常見實(shí)體瘤化療方案選擇湖南省腫瘤醫(yī)院羅以常見實(shí)體瘤化療方案選擇2主要內(nèi)容非小細(xì)胞肺癌大腸癌■乳腺癌■惡性淋巴瘤主要內(nèi)容3非小細(xì)胞肺癌非小細(xì)胞肺癌4Oncology-v.1.2007Non-SmallCellLungCancerndentsStagingTeble1.RevisedStageGroupingofTNMSubsets'tT2TumorwithanyofthefolowingfeaturesofsizeorexentMorethan3cmingreatestdimensionNMSubsetStageTNMSubsetImoyosmainbronchus.2cmormoredistaltothecarinaT1.NO,M0N1MAssociatedwithatelectasisorobstructwepneumonitisthalT4,N2,MOextendstothohilarregionbutdoosnotinvoletheentirelungT3Tumorofenysizethatdirectlyinvadesanyofthefollowing:chestwallndudingsuperorsulcustumors),diaphragm,mediastinalT4N3MOAnyT,anyN,Mtisoftheentirelung4Tumorofaryazthatinvadesarclthefollowingmediastinumheart,grestvassals,trachea,esophagus,vertebralbody.carina;orslagingsnotreavantlaroccutcarcinomadasnslsTx,NO,MoseparatetumornodulesinthesamelobeortumorwithamalgnanttUnedwhhthepsrmiaRianofthaAnOntCommitsonCancer(ACC)uml,SizthEdition(2002)pubiahadbyspinaVatiaNewRegionalLymphNodes(NXRegionallymphnodeNoNoregonalNmphnoomotastass1Metastasetoipsilateralpenbronchalandoripsdatealhilarlymphdos,andintrapulmonarynodesindudinginvolomonbydirectTeble2.RevisedDefinitionof"LensionoftheprimarytumorPrimaryTurmormbythepresenceofmalignantcesinsputumorbronchialwashingsbutnotN3Metastasistocontralateralmediastinal,contralateralhiavisualzndbyimagingorbronchoscopypslateralorcontralateralscalene,orsupraclavicularlymphnode(s)DistantMetastasis(M)fisCarcinomainsituT1Tumor3cmorMXDistantmetastesiscannotbeassessedvisceralpleura,wthoutbronchoscopecevidenceofinvasionmoMoNodstanmetastasisproximalthanthelotarbronchus(u,notnthemainbronchusM1DistantmetastasispresentsContinued0e界,DOi是T白圖,以的以貼w“知響8T41Oncology-v.1.2007Non-Small5Lung(Non-SmallCellCarcinomasT1NOIIABBAJIBIA刂BJIAAABN3M1Lung(Non-SmallCellCarcinomas6四組化療方案對(duì)晚期初治NSCLC患者效果的比較Kubota,KarmanosCRC(Abstract7106,2000.10-2002.6RegimenDrugdosesandRRMedianMedianOneYearOS(%)schedulesTTPOSTC(145n)Paclitaxel32445mo23CarboplatinAUCGP(148nGemcitabine30.14.0mo14.8601g/m2,d1,8ddP80NP(145n)Vinorelbine.314.111.44825mg/m2d1,8DDP80IP(145nIrinotecan60mg/m.04.714.2592d18,15DDP80mg/m2,d1四組化療方案對(duì)晚期初治NSCLC患者效果的比較7目前晚期非小細(xì)胞肺癌治療選擇:二線治療化學(xué)治療■多西他賽(Docetaxel)■培美曲塞(Pemetrexed)靶向治療■特羅凱(Tarceva)■古非替尼(ressa)目前晚期非小細(xì)胞肺癌治療選擇:二線治療8DOc二線治療NSCLCⅢ期臨床試驗(yàn)DOC100mg/m21hq3wksRDOC75mg/m21hg3wksTAX320去甲長春花堿30mgm2d1,8,15q3wks,or異環(huán)磷酰胺2gm2d1,2,3q3wksDOC100,1hg3wksRDOC75mg/m21hq3wksTAX317最好的支持治療(SC)ShepherdFJco2000,FossellaCo2000DOc二線治療NSCLCⅢ期臨床試驗(yàn)9DOC二線治療NSCLOⅢ期臨床試驗(yàn)TAX317TAX320in·14自8---CCC75mgmLogaarkLet,F=00d?654321036912151212210363942454:5157METOPOEEKShepherdFCo2000,FossellaJCo2000DOC二線治療NSCLOⅢ期臨床試驗(yàn)10DOC∨sAlimtaALIMTA(n=280)多烯紫杉醇(n=288)蔌爾中位生存時(shí)間83月一年總體生存率:29.7%中位生存時(shí)間79月年總體生存率329.7%10.012515017520.0DOC∨sAlimta11常見實(shí)體瘤化療方課件講義12常見實(shí)體瘤化療方課件講義13常見實(shí)體瘤化療方課件講義14常見實(shí)體瘤化療方課件講義15常見實(shí)體瘤化療方課件講義16常見實(shí)體瘤化療方課件講義17常見實(shí)體瘤化療方課件講義18常見實(shí)體瘤化療方課件講義19常見實(shí)體瘤化療方課件講義20常見實(shí)體瘤化療方課件講義21常見實(shí)體瘤化療方課件講義22常見實(shí)體瘤化療方課件講義23常見實(shí)體瘤化療方課件講義24常見實(shí)體瘤化療方課件講義25常見實(shí)體瘤化療方課件講義26常見實(shí)體瘤化療方課件講義27常見實(shí)體瘤化療方課件講義28常見實(shí)體瘤化療方課件講義29常見實(shí)體瘤化療方課件講義30常見實(shí)體瘤化療方課件講義31常見實(shí)體瘤化療方課件講義32常見實(shí)體瘤化療方課件講義33常見實(shí)體瘤化療方課件講義34常見實(shí)體瘤化療方課件講義35常見實(shí)體瘤化療方課件講義36常見實(shí)體瘤化療方課件講義37常見實(shí)體瘤化療方課件講義38常見實(shí)體瘤化療方課件講義39常見實(shí)體瘤化療方課件講義40常見實(shí)體瘤化療方課件講義41常見實(shí)體瘤化療方課件講義42常見實(shí)體瘤化療方課件講義43常見實(shí)體瘤化療方課件講義44常見實(shí)體瘤化療方課件講義45常見實(shí)體瘤化療方課件講義46常見實(shí)體瘤化療方課件講義47常見實(shí)體瘤化療方課件講義48常見實(shí)體瘤化療方課件講義49常見實(shí)體瘤化療方課件講義50常見實(shí)體瘤化療方課件講義51常見實(shí)體瘤化療方課件講義52常見實(shí)體瘤化療方課件講義53常見實(shí)體瘤化療方課件講義54常見實(shí)體瘤化療方課件講義55