脾多肽联合同步放化疗治疗局限期小细胞肺癌的临床观察
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江苏省“六大人才高峰”D类资助项目(2015?WSW?041)


A clinical observation of spleen polypeptide injection combined with concurrent chemoradiotherapy for limited⁃stage small cell lung cancer
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    摘要:

    目的:观察脾多肽联合同步放化疗对局限期小细胞肺癌的疗效及细胞免疫功能的影响。方法:选择2013年1月—2017年1月南京医科大学附属肿瘤医院住院治疗的局限期小细胞肺癌患者76例为研究对象,依据治疗方法差异分为对照组38例与观察组38例。对照组仅采用EP方案联合同期放疗治疗,观察组在同期放化疗基础上联合使用脾多肽注射液治疗。比较两组临床疗效、不良反应及治疗过程中T淋巴细胞亚群百分率的变化。结果:①观察组患者治疗后Karnofsky评分(karnofsky performance score,KPS)较治疗前及对照组改善明显,差异有统计学意义(P < 0.05)。观察组近期有效率(完全缓解+部分缓解)为84.2%,对照组为89.5%,两组比较差异无统计学意义。观察组白细胞计数减少发生率为60.5%,低于对照组的84.2%(χ2=5.33,P=0.04)。②与治疗前比较,治疗后观察组患者CD3+、CD4+及CD4+/CD8+水平均显著升高(P < 0.05),而对照组免疫学指标治疗前后无显著变化。③观察组无进展生存时间较对照组长且差异有统计学意义(P=0.03),而两组总生存时间比较差异无统计学意义(P=0.22)。结论:脾多肽联合同步放化疗通过纠正机体免疫功能紊乱,改善并促进细胞免疫功能恢复,延长了患者无进展生存时间,但不能延长患者的总生存时间,对局限期小细胞肺癌有一定辅助治疗作用。

    Abstract:

    Objective:To explore clinical and immune function effect of spleen polypeptide injection combination with concurrent chemoradiotherapy in patients with limited-stage small cell lung cancer(LS-SCLC). Methods:From January 2013 to January 2017,76 LS-SCLC patients were divided randomly into observation and control groups(38 patients in each)from the Affiliated Cancer Hospital of Nanjing Medical University. Control group were given concurrent chemoradiotherapy,and observation group were given the same therapy combined with spleen polypeptide injection. The clinical results,T cell and its subtypes,survival probabilities and adverse reactions were evaluated. Results:The improvement rates of Karnofsky performance score(KPS)in the observation group were significantly better than those in the control group(P < 0.05). The observation and control groups had a similar response rate(84.2% and 89.5%,respectively). When comparing hematologic toxicity,the observat group had a less incidence rate of leucopenia(60.5% vs. 84.2%,χ2=5.33,P=0.04). Compared with pre-treatment,the levels of CD3+,CD4+and CD4+/CD8+ in the observation group were increased and had significant differences(P < 0.05),whereas,the control group had no obviously increasing. The progress-free survival of observation group was significantly improved comparing with that in control group(P=0.03). However,there was no statistic significance in the overall survival between two groups(P=0.22). Conclusion:Spleen polypeptide injection can improve the activity of immune function and prolong PFS of the patients during the chemoradiotherapy for LS-SCLC.

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夏文晋,喻荣彬,姜柏生,刘建良.脾多肽联合同步放化疗治疗局限期小细胞肺癌的临床观察[J].南京医科大学学报(自然科学版),2018,(3):356-359

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  • 收稿日期:2017-10-26
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  • 在线发布日期: 2018-03-19
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