多西他赛联合顺铂治疗晚期肺腺癌患者的临床疗效及其对免疫功能的影响  

Clinical Efficacy of Docetaxel Combined with Cisplatin in the Treatment of Advanced Lung Adenocarcinoma and the Impact on Immune Function of Patients

作　　者：付茂月 雷开键[1] 贾钰铭[1] 陈洁[1] 舒艳玲 FU Maoyue;LEI Kaijian;JIA Yuming;CHEN Jie;SHU Yanling(Cancer Center,Yibin Second People's Hospital,Yibin 644000,China)

机构地区：[1]四川省宜宾市第二人民医院肿瘤中心,644000

出　　处：《实用心脑肺血管病杂志》2021年第8期48-53,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：背景肺腺癌是临床最常见的肺部恶性肿瘤,较易发生远处转移。顺铂、多西他赛是临床治疗肺腺癌的主要药物。目的探讨多西他赛联合顺铂治疗晚期肺腺癌患者的临床疗效及其对免疫功能的影响,以期为临床治疗提供参考。方法选取宜宾市第二人民医院2014年3月—2020年3月收治的晚期肺腺癌患者120例,采用随机数字表法分为对照组和观察组,各60例。对照组患者采用紫杉醇联合顺铂治疗,观察组患者采用多西他赛联合顺铂治疗,两组患者均持续化疗2个周期。比较两组患者的临床疗效及治疗前后癌因性疲乏量表(CFS)评分、肿瘤标志物〔癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)和细胞角蛋白19片段(CYFRA21-1)〕、免疫功能指标〔CD3^(+)细胞分数、CD4^(+)细胞分数、CD8^(+)细胞分数和自然杀伤(NK)细胞分数〕,并观察两组患者毒副作用发生情况及1年存活情况。结果观察组患者临床疗效优于对照组(P<0.05)。两组患者治疗前躯体疲乏评分、情感疲乏评分、认知疲乏评分、CFS总分及治疗后躯体疲乏、情感疲乏、认知疲乏评分比较,差异无统计学意义(P>0.05);观察组患者治疗后CFS总分低于对照组(P<0.05)。两组患者治疗前CEA、NSE、CYFRA21-1水平及CD3^(+)、CD4^(+)、CD8^(+)、NK细胞分数比较,差异无统计学意义(P>0.05);观察组患者治疗后CEA、NSE和CYFRA21-1水平低于对照组,CD3^(+)、CD4^(+)、CD8^(+)、NK细胞分数高于对照组(P<0.05)。观察组患者毒副作用发生率低于对照组(P<0.05)。两组患者1年存活率比较,差异无统计学意义(P>0.05)。结论多西他赛联合顺铂治疗晚期肺腺癌患者的临床疗效确切,可有效提高患者免疫功能,抑制病情进展,且未增加毒副作用。Background Lung adenocarcinoma is the most common malignant lung tumor in clinic,which is prone to distant metastasis.Cisplatin and docetaxel are the main drugs in the clinical treatment of lung adenocarcinoma.Objective To investigate the clinical efficacy of docetaxel combined with cisplatin in the treatment of advanced lung adenocarcinoma and the impact on immune function of patients,in order to provide reference for clinical treatment.Methods A total of 120 patients with advanced lung adenocarcinoma in Yibin Second People's Hospital from March 2014 to March 2020 were selected,and they were divided into the control group and the observation group according to random number table method,60 cases in each group.The patients in the control group were treated with paclitaxel combined with cisplatin,while the patients in the observation group were treated with docetaxel combined with cisplatin,both groups were treated with two cycles.The clinical efficacy and Cancer Fatigue Scale(CFS)score,tumor markers[carcinoembryonic antigen(CEA),neuron specific enolase(NSE)and cytokeratin 19 fragment(CYFRA21-1)],immune function indexes[CD3^(+)cell fraction,CD4^(+)cell fraction,CD8^(+)cell fraction and natural killer(NK)cell fraction]before and after treatment were compared between the two groups.Incidence of toxic and side effects and 1-year survival were observed of the two groups.Results The clinical efficacy of the observation group was better than that of the control group(P<0.05).There was no significant difference in physical fatigue score,emotional fatigue score,cognitive fatigue score,total CFS score before treatment and physical fatigue score,emotional fatigue score,cognitive fatigue score after treatment between the two groups(P>0.05);the total CFS score of the observation group was lower than that of the control group after treatment(P>0.05).There was no significant difference in the levels of CEA,NSE,CYFRA21-1 and CD3^(+)cell fraction,CD4^(+)cell fraction,CD8^(+)cell fraction,NK cell fraction between the two groups be

关 键 词：肺腺癌 多西他赛 顺铂 肿瘤标志物 免疫功能 毒副作用 治疗结果 

分 类 号：R730.261.1[医药卫生—肿瘤]