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长江大学学报(自然科学版) 2015年第12期12卷 25-28+4-5页

作者： chaurasia prasad bidyanand 田夫胡小苗向进见蒋雪峰肖宝来谢建平长江大学临床医学院荆州市第一人民医院普通外科

目的:观察腹腔镜切除术联合伊马替尼治疗胃肠道间质瘤的临床疗效,探讨影响预后的因素。方法:选取2008年1月至2012年5月在医院治疗的胃肠道间质瘤患者70例,随机分成两组,研究组35例和对照组35例。研究组患者采用腹腔镜切除术后给予伊马替... 详细信息

目的:观察腹腔镜切除术联合伊马替尼治疗胃肠道间质瘤的临床疗效,探讨影响预后的因素。方法:选取2008年1月至2012年5月在医院治疗的胃肠道间质瘤患者70例,随机分成两组,研究组35例和对照组35例。研究组患者采用腹腔镜切除术后给予伊马替尼400mg/次,1次/d;对照组患者只采用腹腔镜切除术治疗。对两组患者的生存率与复发率进行随访统计,并分析影响预后的因素。结果:研究组和对照组患者1年无复发,生存率分别为100%和82.9%。2年无复发,生存率分别为94.3%和62.9%。术后使用伊马替尼辅助治疗能明显延长患者无复发生存时间。中危患者中,两组无复发,生存率无明显异常;高危患者中,研究组2例(5.7%)出现复发转移,对照组有13例(37.1%)出现肿瘤复发转移,两组无复发、生存率差异显著。危险度、肿瘤大小、有丝分裂数和伊马替尼辅助治疗是影响预后的独立性因素。结论:腹腔镜切除术联合伊马替尼治疗中危或高危胃肠道间质瘤患者能显著改善预后,提高其无复发生存率,治疗效果在高危患者中最为明显。

关键词：腹腔镜切除术伊马替尼胃肠道间质瘤

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腹腔镜切除术联合伊马替尼治疗胃肠道间质瘤的临床观察

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长江大学学报（自科版）（下旬） 2015年第4期12卷 25-28页

作者： chaurasia prasad bidyanand 田夫胡小苗向进见蒋雪峰肖宝来谢建平长江大学临床医学院荆州市第一人民医院普通外科湖北荆州434000

关键词：腹腔镜切除术伊马替尼胃肠道间质瘤

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A rare case of langerhans cell histiocytosis of the gastrointestinal tract

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World Journal of Gastroenterology 2012年第12期18卷 1410-1413页

作者： Uday Shankar Monika prasad Om P chaurasia Internal Medicine Mount Sinai School of Medicine at Queens Hospital CenterJamaicaNY 11432United States Department of Medicine University of CaliforniaIrvineCA 92697United States

Langerhans cell histiocytosis （LCH） is a group of idiopathic disorders characterized by the proliferation of specialized, bone marrow-derived langerhans cells and mature eosinophils. The clinical spectrum ranges from an acute, fulminant, disseminated disease called Letterer Siwe disease to solitary or few, indolent and chronic lesions of the bone or other organs called eosinophilic granuloma. Involvement of the gastrointestinal tract is very rare in LCH. We present the case of a 53-year-old woman referred by her primary care physician for a screening colonoscopy. A single sessile polyp, measuring 4 mm in size, was found in the rectum. Histopathological examination revealed that the lesion was relatively well circumscribed and comprised mainly a mixture of polygonal cells with moderate-to-abundant pink slightly granular cytoplasm. The nuclei within these cells had frequent grooves and were occasionally folded. Immunohistochemical staining was positive for CD la which confirmed the diagnosis of LCH. On further workup, there was no evidence of involvement of any other organ. On follow up colonoscopy one year later, there was no evidence of disease recurrence. Review of the published literature revealed that LCH presenting as solitary colonic polyp is rare. However, with the increasing rates of screening colonoscopy, more colonic polyps may be identified as LCH on histopathology. This underscores the importance of recognizing this rare condition and ensuring proper follow-up to rule out systemic disease.

关键词： Langerhans cells Histiocytosis Colonic pol-yp CD-la Eosinophilic granuloma Screening Colono-scopy

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Iridium Implantation in T1 and T2 Cancers of Anterior Tongue: Report from B. P. Koirala Memorial Cancer Hospital, Nepal

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2012年第3期1卷 73-77页

作者： Vijayakumar Narayanan Bibek Acharya chaurasia Pradumna prasad Dejkumar Gautam Clinical Director Cancer Care Kenya Nairobi Kenya Department of Otorhinolaryngology B. P. Koirala Memorial Cancer Hospital Bharatpur Nepal Department of Radiation Oncology B. P. Koirala Memorial Cancer Hospital Bharatpur Nepal

Early stage cancers of tongue are treated traditionally with a wide local excision or hemiglossectomy, but the preservation of normal speech and swallowing are hampered. Most of the patients are treated with external beam irradiation to achieve the best locoregional control as only a limited number of tongue cancers can be excised. Underdeveloped nations with finite resources are still dependent on cobalt based external beam radiotherapy and sometimes a Linear Accelerator with two dimensional planning. This treatment has many limitations, as the large radiation fields irradiate not only the tumor but also normal tissue. The sequalae include mucositis, dry mouth, teeth and gum injury, spinal cord damage and rarely mandibular necrosis. Intensity modulated radiotherapy, which can abrogate these side effects, is not available to these patients. Irradiation using implanted solid radioactive sources into the tumor tissue is a viable option in this context. This kind of treatment is termed as brachytherapy and if the implant is introduced into the tissue then it is interstitial brachytherapy. This report details our experience in interstitial implantation, planning, dosimetry and treatment. Diagnosed cancers of anterior 2/3rd of lateral border of tongue with T1 N0M0 or T2 N0M0 stages were subjected to Iridium implantation under general anesthesia. Orthogonal films were taken and planning done with brachyvision treatment planning system. High dose rate radiotherapy was delivered as per the prescription. Excellent local control of the tumor was achieved with no undue morbidity to the adjacent structures. The patients were asked to undergo regular follow up. Surgical salvage was advised in cases of nodal recurrence. Interstitial implantation is a treatment that can be safely administered in early stage cancers of the tongue. This has remarkable efficacy and is also a patient friendly procedure.

关键词： Oral Cavity Cancer Interstitial Brachytherapy Implantation Remote After loader

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