奥沙利铂热化疗治疗Ⅳ期消化道肿瘤的疗效与对患者免疫功能的影响  

Effect of oxaliplatin-based chemotherapy on stage Ⅳ gastrointestinal tumors and its effect on immune function

作　　者：肖杨[1] 赵鹏[1] 王大庆[1] 侯倩倩[1] 杨芳[1] 石庆芳[1] XIAO Yang;ZHAO Peng;WANG Da-Qing;HOU Qian-Qian;YANG Fang;SHI Qing-Fang(Department of Oncology,Harrison Internation Peace Hospital,Hengshui 053000,China)

机构地区：[1]哈励逊国际和平医院,衡水053000

出　　处：《中国免疫学杂志》2019年第4期440-445,共6页Chinese Journal of Immunology

基　　金：衡水市科技支撑计划项目(No.15011)

摘　　要：目的:探讨奥沙利铂热化疗在Ⅳ期消化道肿瘤患者中的疗效观察及对患者免疫功能的影响。方法:选择2011年1月～2017年1月入院治疗的Ⅳ期消化道肿瘤患者160例,根据治疗方案不同分为对照组80例和观察组80例。对照组采用130 mg/m^2奥沙利铂全身静脉化疗,观察组在对照组基础上联合深部热疗增敏治疗。两组均连续治疗2个周期,治疗完毕后对两组疗效进行评估。采用实体瘤疗效评价标准(RECIST1.1)对两组疗效率进行评估;采用流式细胞仪测定两组治疗前和2周期治疗后CD3^+、CD4^+、CD8^+及CD4^+/CD8^+及自然杀伤(NK)细胞水平;采用国立癌症研究所毒性判断标准(NCI-CTC)4.0标准对两组毒副反应发生率进行评估;对两组进行36个月随访,记录并统计两组生存期并绘制OS曲线,比较两组临床疗效及对患者免疫功能的影响。结果:观察组采用奥沙利铂热化疗治疗后疗效率为47.50%,高于对照组25.00%(P<0.05)。观察组与对照组2周期治疗后CD3^+、CD4^+、CD4^+/CD8^+水平高于治疗前(P<0.05);观察组与对照组2周期治疗后CD8^+水平低于治疗前(P<0.05);观察组2周期治疗后CD3^+、CD4^+、CD4^+/CD8^+水平高于对照组(P<0.05);观察组2周期治疗后CD8^+水平低于对照组(P<0.05)。观察组2周期治疗后白细胞、血红蛋白、血小板、脱发、消化道症状及周围神经症状等毒副反应发生率均低于对照组(P<0.05)。对两组均进行36个月随访,观察组治疗后中位生存期为15.68个月,长于对照组8.84个月(P<0.05)。结论:奥沙利铂热化疗用于Ⅳ期消化道肿瘤患者中有助于提高临床疗效,改善机体免疫功能,不会增加毒副反应发生率,能延长患者生存期,值得推广应用。Objective:To investigate the efficacy of oxaliplatin in the treatment of patients with stageⅣdigestive tract cancer and its effect on immune function.Methods:A total of 160 patients with stage IV digestive tract cancer who were admitted to hospital from January 2011 to January 2017 were enrolled.According to the treatment plan,80 patients in the control group and 80 patients in the observation group were selected.The control group received 130 mg/m 2 oxaliplatin systemic intravenous chemotherapy,and the observation group was combined with deep hyperthermia sensitization on the basis of the control group.Both groups were treated continuously for 2 cycles,and the efficacy of the two groups was evaluated after the treatment.The efficacy rate of the two groups was evaluated by the solid tumor efficacy evaluation standard(RECIST1.1).The CD3^+,CD4^+,CD8^+and CD4^+/CD8^+and natural killer(NK)cells were measured by flow cytometry before and after 2 cycles of treatment;assessment of the incidence of toxic side effects using the National Cancer Institute Toxicity Judging Criteria(NCI-CTC)4.0;follow-up was performed for 36 months in both groups,and the survival of the two groups was recorded and the OS curve was drawn.The clinical efficacy of the two groups and the impact on the patient′s immune function.Results:After treatment with oxaliplatin thermochemotherapy,the response rate was 47.50%in the observation group,which was higher than that in the control group(25.00%)(P<0.05).The levels of CD3^+,CD4^+,CD4^+/CD8^+in the observation group and the control group were higher than those before treatment(P<0.05).The CD8^+level in the observation group and the control group after 2 cycles of treatment was lower than that before treatment(P<0.05).The levels of CD3^+,CD4^+,CD4^+/CD8^+in the observation group were higher than those in the control group(P<0.05).The level of CD8^+in the observation group was lower than that in the control group(P<0.05).The incidence of toxic side effects such as white blood cells,hemoglobin,platel

关 键 词：奥沙利铂 热化疗 Ⅳ期消化道肿瘤 顺铂 免疫功能 毒副反应 生存期 

分 类 号：R73[医药卫生—肿瘤]