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您的检索式：作者名="Joseph M.Herman"
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| 1 | 肝门部胆管癌的诊断、治疗选择与处理策略显示文摘肝门部胆管癌(HC)是一种少见的疾病,通常在60岁左右发病,预后较差;在美国,每年约有3 000例患者被诊断为该病,但仅有不到一半的人可以行手术治疗;有多种因素与HC的发病有关,最常见的有原发性硬化性胆管炎(PSC),胆石症以及寄生虫肝病。患者通常表现为腹痛、瘙痒、体质量减轻和黄疸。CT、MRI及超声可以用来发现胆道病损;逆行性胰胆管造影术(ERCP)及经皮肝胆管造影术(PTC)在评估肿块位置、长度的同时还可以行治疗性的胆汁引流。MRCP在辨别肿瘤延伸范围时同PTC及ERCP有相同的准确性,并且并发症较前两者少。HC的治疗方式主要为手术切除、放射治疗、化疗及光动力学治疗。残余肝脏胆汁引流有助于降低胆红素水平,进而促进残肝的生长;标准的治疗包括切缘为阴性切除(R0),范围为肝外胆管切除、肝切除及周围的淋巴结清扫术;局部的切除术是不适当的;淋巴结侵犯的程度、肿瘤的级别以及切缘的性质是重要的预后指标;如果无法行肿瘤切除,那么在经反复选择后的患者中实施肝移植术也是种可行的方式;尽管数据有限,化疗对于不可切除的患者来说仍有一定的作用;经手术切除的HC患者5年生存率约为10%~40%,然而即使为R0切除,复发率也高达50%~70%。由于这种疾病的复杂性,多种学科的综合治疗是较为理想的治疗方式。 | Kevin C.Soares Ihab Kamel David P.Cosgrove Joseph M.Herman Timothy M.Pawlik 冯铁成 李新营 | 2014 | 中国普通外科杂志2014，23，8： | 15 |
| 2 | Advances of stereotactic body radiotherapy in pancreatic cancer显示文摘Pancreatic cancer(PCA) is one of the most aggressive tumors with few effective treatment modalities. It is the 4th and 7th leading cause of cancer death in the United States and China, respectively. At the time of diagnosis, only 20% of cases present with a resectable tumor, and about 40% with a locally advanced tumor that is considered unresectable. Even resected patients still have a poor prognosis, with an incidence of local recurrence ranging from 20% to 60%. It is also reported that up to 30% of PCA patients die from locally obstructive disease with few or no distant metastases. These findings have highlighted the importance of local radiation therapy in the treatment of PCA. As the role of conventional chemoradiotherapy remains controversial, the dawn of the pancreas stereotactic body radiation therapy(SBRT) era represents a potential paradigm shift in the management of PCA. SBRT delivers a higher biological effective dose to the tumor with sharp dose escalation in a shorter treatment time course. Pancreas SBRT is a novel therapeutic option to achieve local tumor control with minimal toxicity. Herein, we review the advancement of SBRT for PCA patients with different stages of pancreatic adenocarcinoma. | Qichun Wei Wei Yu Lauren M.Rosati Joseph M.Herman | 2015 | Chinese Journal of Cancer Research2015，27，4： | 5 |
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