榄香烯乳联合化疗治疗晚期胰腺癌的临床疗效及安全性  

Clinical efficacy and safety of elemene emulsion injection combined with chemotherapy in the treatment of advanced pancreatic cancer

作　　者：周兴芹[1] 赵洪瑜[1] 常仁安[1] 沈超艳 孙洁 韩杰 季斌[1] ZHOU Xingqin;ZHAO Hongyu;CHANG Ren' an;SHEN Chaoyan;SUN Jie;HAN Jie;JI Bin(Department of Radiotherapy,Affiliated Hospital of Nantong University,Jiangsu Nantong 226001,China)

机构地区：[1]南通大学附属医院肿瘤放疗科,江苏南通226001

出　　处：《现代肿瘤医学》2022年第14期2576-2580,共5页Journal of Modern Oncology

基　　金：江苏省政府留学基金项目(编号:苏教外函[2019]43号);吴阶平医学基金项目(编号:320.6750.2020-18-1);江苏省南通市科技计划项目(编号:JCZ19092);江苏省南通市卫健委面上项目(编号:MB2019054)。

摘　　要：目的:探讨榄香烯乳注射液联合化疗治疗晚期胰腺癌的临床疗效及安全性。方法:选取我院收治的120例患者,随机分为对照组60例和观察组60例。对照组给予吉西他滨1000 mg/m^(2),静滴d_(1)、d_(8),奥沙利铂85 mg/m^(2) d_(1)。观察组在此基础上给予榄香烯乳状注射液440 mg/次,1日一次,连续注射7 d,21 d为一疗程。采用流式细胞仪测定治疗前后T细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)细胞率以及CD4^(+)/CD8^(+))变化。评价两组患者在治疗中的临床疗效、免疫功能指标、生活质量及不良反应。结果:两组患者均完成了2~4周期化疗。近期疗效比较:对照组总有效率为33.33%,观察组总有效率为46.67%(P=0.015)。远期疗效比较:观察组中位生存期为13.5个月,对照组中位生存期为7.9个月。观察组1、2、3年生存率分别为50.00%、35.00%、20.00%,对照组1、2、3年生存率分别为33.33%、18.33%、10.00%,两组生存率比较有统计学差异(P<0.05)。外周血T细胞亚群:与对照组相比,观察组CD8^(+)水平明显升高(P=0.017),CD4^(+)/CD8^(+)比值明显降低(P=0.034)。两组患者生活质量评分结果显示,观察组治疗后的评分[(79.4±7.1)分]与对照组[(71.3±5.8)分]相比有统计学差异(P=0.017)。在不良反应发生率方面,观察组的骨髓抑制、贫血、肝肾功能损伤、恶心呕吐、乏力发生率明显低于对照组(P<0.05),而在脱发、腹泻发生率方面两组相比无统计学差异(P>0.05)。结论:榄香烯乳联合化疗能显著提高晚期胰腺癌的疗效,提高患者免疫力,改善生活质量,降低化疗药物毒副反应,且安全性高,值得临床推荐作为治疗晚期胰腺癌的综合治疗手段之一。Objective:To investigate the clinical efficacy and safety of elemene emulsion injection combined with chemotherapy in the treatment of advanced pancreatic cancer.Methods:120 patients in our hospital were randomly divided into control group(n=60)and observation group(n=60).The control group was given gemcitabine 1000 mg/m^(2),intravenous drip d_(1),d_(8) and oxaliplatin 85 mg/m^(2) d_(1).On this basis,the observation group was given elemene emulsion injection 440 mg/time,once a day,continuous injection for 7 days,21 days as a course of treatment.T cell subsets(CD3^(+),CD4^(+),CD8^(+) and CD4^(+)/CD8^(+))were measured by flow cytometry.The clinical efficacy,immune functional index,quality of life and adverse reactions of the two groups were evaluated.Results:The groups of patients completed 2~4 cycles of chemotherapy.The short-term efficacy result showed that the total response rate of the control group was 33.33%and the total response rate of the observation group was 46.67%(P=0.015).The long-term efficacy result showed the median survival time of the observation group was 13.5 months and the median survival time of the control group was 7.9 months.1-,2-and 3-year survival rates were 50.00%,35.00%,20.00%in the observation group,and 1-,2-and 3-year survival rates were 33.33%,18.33%,10.00%in the control group.The survival rates of the two groups were significantly different(P<0.05).Compared with the control group,the level of CD8^(+) in the observation group was significantly increased(P=0.017),and the ratio of CD4^(+)/CD8^(+) was significantly decreased(P=0.034).There was significant difference in quality of life between the observation group[(79.4±7.1)scores]and the control group[(71.3±5.8)scores](P=0.017).The incidence of adverse reactions,such as myelosuppression,anemia,liver and kidney function injury,nausea and vomiting,feeble in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the incidence of lipsotrichia and diarrhea between the tw

关 键 词：榄香烯 免疫功能 临床疗效 晚期胰腺癌 

分 类 号：R735.9[医药卫生—肿瘤]