Objective To investigate the clinical efficacy and side effects of sequential and concurrent chemoradiation in the treatment of colorectal cancer.Methods 90 patients with colorectal cancer were divided into ⅡAof 21 cases (Ⅱa group),Ⅲa of 24 cases (Ⅲa group),Ⅱb of 23 cases (Ⅱb group),Ⅲb of 22 cases (Ⅲa group) according to the stage of the disease.Group Ⅱa and Ⅲa were treated by sequential chemoradiation therapy,Ⅱb group and Ⅲb group were treated by concurrent chemoradiation therapy.The clinical efficacy and toxicity were observed and compared.Results All patients were followed up at 1 and 3 years,no one lost and died.1-year and 3-year OS and PFS between group Ⅱa and group Ⅱb had no significant differences (P ＞ 0.05).1-year OS had no significant difference between Ⅲa group and Ⅲb group (P ＞ 0.05),1-year PFS,3-year OS and PFS had significant differences (x2 =3.993,4.224,4.304,all P ＜ 0.05).The incidence rate of toxicities between Ⅱa group +Ⅲa group (28.89％) and group Ⅱb+ Ⅲb (51.11％) had significant difference (x2 =4.629,P ＜ 0.05) ; while for each system specific incidence rate of side effects had no significant difference (P ＞ 0.05).Conclusion Compared with sequential chemotherapy in the treatment of colorectal cancer,concurrent chemoradiotherapy can effectively prolong overall survival and progression-free survival time,and can reduce the costs of treating,although increasing the treatment toxicity,but still within the acceptable range of patients,it has better application value in clinical.

Objective To investigate the advantage of two-way shrinking field radiotherapy with high intensity on non-small cell lung cancer(NSCLC) with stage Ⅳ.Methods Forty-two old NSCLC patients with stage Ⅳ were selected as our subjects who cannot performed surgery in the People's Hospital of binzhou.The patients all underwent CT-scan and the CT information was input TPS planning system in order to outlined gross tumor volume(GTV1) and make plan 1 with the first three-dimensional conformal radiotherapy 50 Gy/25 F～ 54 Gy/27 F.Then the 2nd CT-scan was performed to sketch GTV2 and make Plan 2.The detail of Plan 2 was that the amount of radiation was increased to the total 66 Gy/33 F ～ 70 Gy/35 F,two radiotherapy plans in accordance with 1 times/d,5 times/weeks;chemotherapy with paclitaxel 40 mg/m2,weekly radiotherapy before the intravenous infusion,once every 6 weeks.Results The median of reduce tumor size between GTV2 and GTV1 was 68.85 cm3 and relative reduce tumor size was 28.32％.As to short-term effect,there were 5 cases with total recovery(1 1.9％),25 cases with partly recovery(59.5％),10 cases with stable stage (23.8 ％),2 cases with development(4.8％).Local control rate regarding of tumor development was 71.4％ at 1-yrea period and 23.8％ at 2-year periods.Survival rate was 73.8％(31/42) at 1 year and 28.6％(12/42) at 2-year.Side effects included radiation esophagitis and radiation pneumonitis based,radiation-induced lung injury.Condusion The therapy scheme of two-way three-dimensional conformal radiation dosage treatment of NSCLC,GTV and re-plan outlined dosage can increase the target dose,radiation therapy to reduce side effects.

Objective To study of cellular immune function change of elderly patients with non-small car-cinoma after chemotherapy.Methods 62 patients with non-small carcinoma by age was divided into elderly group (≥60 years old)and youth group (<60 years old).The lymphocytes and their subsets CD3,CD4,CD8 levels were detected respectively in 2 weeks after chemotherapy and chemotherapy before compared with 20 cases of healthy vol-unteers.Results The immune condition of CD3[(51.87 ±2.56)%,(58.98 ±3.87)%]and CD4[(35.01 ± 5.12)%,(42.12 ±3.54)%],CD4/CD8[(0.89 ±0.49)%,(1.08 ±0.86)%]levels were significantly lower than those of healthy controls.Two groups of patients compared with healthy group CD3(69.38 ±8.54)%,CD4(48.21 ± 3.45)%,CD4/CD8(1.87 ±0.85)%(t=10.586,5.998,10.087,6.093,5.170,3.236,all P<0.05),and CD8 [(32.68 ±3.64)%,(30.24 ±2.45)%]levels were higher than those of healthy controls (26.10 ±2.89%)(t=6.777,5.531,all P<0.05);The CD3 and CD4,CD4/CD8 of elderly group patients were markedly lower than that of young patients (t=8.472,6.394,3.059,all P<0.05).The CD8 levels of the elderly group was higher than young patients (t=3.114 2,P<0.05);The Elderly group and young patients after 2 cycles of chemotherapy CD3 signifi-cantly was lower than before treatment (t=10.233,16.847,all P<0.05),but the two groups of patients with CD4, CD8 and CD4/CD8 levels before and after treatment (P>0.05);There was no significant difference with CD3 level of the two groups of patients after chemotherapy (P>0.05);The CD3 level of the two groups of patients after chemo-therapy was no significant difference (P>0.05),the elderly group patients after chemotherapy with CD4 levels was lower than young patients (t=7.130,P<0.05).The CD8 and CD4/CD8 level of the two groups after chemotherapy were no significant difference (P>0.05);The CD3 levels of patient withⅠ-Ⅱ stage were significantly better than patients withⅢ-Ⅳstage (t=1.584,1.721,all P<0.05),the CD4,CD8 and CD4/CD8 level of the two groups had no significant difference(P>0.05).Conclusion The senile non-small carcinoma patients need assistance targeted immunotherapy,also need to adjust according to the patient's age and clinical staging in patients with chemotherapy drug doses.