加味升降散联合FOLFIRINOX新辅助化疗方案对局部进展期胰腺癌患者的影响  

Effect of modified Shengjiang Powder combined with neoadjuvant chemotherapy with FOLFIRINOX in patients with locally advanced pancreatic cancer

作　　者：蒋庭德 魏铮[1] JIANG Tingde;WEI Zheng(Department of Traditional Chinese Medicine,Deyang People's Hospital,Deyang,Sichuan 618000)

机构地区：[1]四川省德阳市人民医院中医科,四川德阳618000

出　　处：《河北中医》2024年第8期1297-1300,共4页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察加味升降散联合FOLFIRINOX新辅助化疗方案对局部进展期胰腺癌患者的影响。方法将84例局部进展期胰腺癌患者按照随机数字表法分为2组,对照组42例予基础治疗^(+)FOLFIRINOX新辅助化疗,治疗组42例在对照组基础上予加味升降散治疗。每2周为1个化疗周期,共治疗6个化疗周期。比较2组治疗前后血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原50(CA50)、CA19-9、CA242]、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、生活质量综合评定量表(GQOL-74)评分,统计2组化疗效果、不良反应情况。结果治疗组客观缓解率23.81%(10/42),对照组客观缓解率7.14%(3/42),治疗组疗效优于对照组(P<0.05)。2组治疗后血清CEA、CA50、CA19-9、CA242水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较本组治疗前明显升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05);2组治疗后CD8^(+)水平较本组治疗前明显降低(P<0.05),且治疗组低于对照组(P<0.05)。2组治疗后GQOL-74各维度评分均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。治疗组不良反应总发生率11.90%,对照组为35.71%,治疗组低于对照组(P<0.05)。结论加味升降散联合FOLFIRINOX新辅助化疗方案治疗局部进展期胰腺癌患者,可有效控制病情进展,增强免疫力,提高生活质量,且不良反应小,预后良好。Objective To observe the effect of modified Shengjiang Powder combined with neoadjuvant chemotherapy with FOLFIRINOX(folinic acid,fluorouracil,irinotecan,and oxaliplatin)in patients with locally advanced pancreatic cancer(LAPC).Methods A total of 84 LAPC patients were randomly assigned into treatment group(n=42)and control group(n=42).All patients were managed by conventional therapy^(+)neoadjuvant chemotherapy with FOLFIRINOX,and those in treatment group were additionally treated with modified Shengjiang Powder.The treatment continued for 6 chemotherapy cycles(1 cycles for 2 weeks),aiming to compare serum tumor markers(carcinoembryonic antigen[CEA],carbohydrate antigen 50[CA50],CA19-9,CA242),T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),generic quality of life inventory-74(GQOL-74).The chemotherapy effect and adverse reactions were assessed.Results The objective remission rate in the treatment group was better than that in the control group(23.81%[10/42]vs 7.14%[3/42],P<0.05).After treatment,CEA,CA50,CA19-9,CA242 in the both groups were significantly decreased(P<0.05),which were significantly lower in the treatment group than in the control group(P<0.05).Significantly increased CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and decreased CD8^(+)were found in the both groups(all P<0.05),and the treatment group was superior to the control group for CD3^(+),CD4^(+),CD4^(+)/CD8^(+),CD8^(+)(all P<0.05).After treatment,the dimension score of GQOL-74 in the both groups were significantly increased(P<0.05),which was significantly higher in the treatment group than in the control group(P<0.05).The total incidence of adverse reactions in the treatment group was significantly lower than that in the control group(11.90%vs 35.71%,P<0.05).Conclusion Modified Shengjiang Powder combined with neoadjuvant chemotherapy with FOLFIRINOX can effectively control disease progression,enhance immunity,and improve quality of life in LAPC patients,and it had less adverse reactions and good prognosis.

关 键 词：胰腺癌 抗肿瘤联合化疗方案 加味升降散 辅助 预后 

分 类 号：R735.9[医药卫生—肿瘤]