Objective:To evaluate the curative efficacy,clinical benefit response (CBR),survival length and toxicity of radiochemotherapy combined with 24 hours continuous infusional gemcitabine for locally advanced unresectable pancreatic adenocarcinoma.Methods:20 patients with histologically or cytologically confirmed locally advanced unresectable pancreatic adenocarcinoma were enrolled into this trial,all of whom had bidimensionally measurable disease that could be assessed by radiographic procedures.Gemcitabine was administered as a 24 hours continuous infusion once weekly for 3 of 4 weeks.Radiation therapy was 3 dimensional conformal radiation therapy (3DCRT),using megavolt irradiation(total dose,45Gy,1.8/Gy/day) of 6MV photons or greater with a 3 or 4-field technique which was delivered concurrently for 5 weeks.Results:Only 2 partial response was observed(10%),and disease was stabilized in 13 additional patients(65%).The median time to progression was 6.5 months (range, 2～13 months).Although all patients developed distant metastases,locoregional failure occurred in only 4.The median survival time was 9.6months (range,3～23.0~+months),and 1-year survival rate was 14.3%.Positive CBR was 14/17(82.4%).The main side effects included slight liver function damage and neutropenia,thrombocytopenia,hypochromia.Conclusion:Gemcitabine when given as prolonged infusion in 130mg/m~2/week combined with 3DCRT is feasible and effective for local control of pancreatic cancer and CBR,but essentially ineffective in counteracting metastatic tumor growth.

0.05).The median time to progression (mTTP) was 7.8 months in HCPTOX group and 7.9 months in FOLFOX4 group, respectively. The median survival time (MST) was 13.1 months in HCPTOX group and 13.3 months in FOLFOX4 group, respectively. The toxicities were well tolerated.The incidence of grade Ⅲ+Ⅳ nausea and vomiting was significantly lower in HCPTOX group than in FOLFOX4 group (?2=4.538,P0.05). Conclusion:Both of the two regimens were feasible, well tolerated and effective in treatment of metastatic colorectal cancer.HCPTOX regimen might be safer than FOLFOX4 regimen,especially in elderly patients or patients with ECOG PS of 1 to 2.

Objective: To explore the reasonable compatibility of anesthetics in painless small intestinal endoscopy by comparing the influence of different target plasma propofol concentrations combined with remifentanil on anesthesia effects and respiratory and circulatory functions.Methods: Two hundred patients requiring small intestinal endoscopy were randomly divided into 4 groups,Group Ⅰ given 1% propofol only,with the target plasma propofol concentration set at 4.5 ?g/ml,and Group Ⅱ,Ⅲ and Ⅳ receiving 30-second injection of remifentanil(0.3 ?g/kg) 1 min before target-controlled infusion(TCI) of propofol,with the target plasma propofol concentration set at 3.0,3.5 and 4.0 ?g/ml,respectively.The mean arterial pressure(MAP),heart rate(HR),pulse oxygenation(SpO2),induction time,awakening time,orientation recovery time and the incidence of patients' body motion were observed before anesthesia,at the vanishment of the eyelash reflex,while the small intestine endoscope passing through the Treitz ligament or ileoceal valve and after endoscopy.Results: Compared with baseline values,MAP and HR were significantly decreased in all groups when the eyelash reflex vanished,markedly increased in Group Ⅰ,although not so obvious in Groups Ⅱ and Ⅲ,when the small intestinal endoscope passed through the Treitz ligament or ileoceal valve,and greatly reduced at all time points in Group Ⅳ,with difficult entrance of the small intestine endoscope due to low tension of the intestinal cavity.Comparatively,the induction time was shorter and the awakening time and orientation recovery time were longer in Group Ⅰ,the total dose of propofol and the incidence of body motion notably decreased in Groups Ⅱand Ⅲ,and the incidence of respiratory depression obviously increased in Group Ⅳ.Conclusion: Propofol TCI combined with remifentanil can be used safely and effectively in painless small intestinal endoscopy.Target plasma propofol concentration(3.5 ?g/ml) in combination with remifentanil(0.3 ?g/kg) gives more efficient anesthesia,lower incidence of body motion and respiratory suppression and better recovery.Therefore,it is the suitable anesthetic compatibility in painless small intestinal endoscopy.