云芝糖肽配合化疗对卵巢和子宫体癌患者免疫功能及生活质量的影响(英文)

Effect of polysaccharide-peptide plus chemotherapy on the immune function and quality of life in patients with ovarian or endometrial cancer

背景:生物反应调节剂己成为继化疗、手术及放疗后第4种治疗肿瘤的方法。云芝糖肽是一种生物反应调节剂物质,在肿瘤治疗中具有重要作用,己被应用于胃癌、肺癌、食道癌等的治疗。目的:观察云芝糖肽对因妇科恶性肿瘤而化疗的患者免疫功能与生活质量的影响。设计:对比观察。单位:上海交通大学附属第一人民医院妇产科。对象:选择1999-06/2002-12上海交通大学附属第一人民医院妇产科已手术确诊的妇科恶性肿瘤住院患者共40例。其中卵巢癌36例,平均年龄52岁;子宫体癌4例,平均年龄54岁。纳入标准:卵巢或子宫体癌患者,手术后没有化疗禁忌征。排除标准:有化疗禁忌征的患者。方法:将患者按期别及年龄配对分成试验组和对照组,每组20例。试验组接受化疗加云芝糖肽;对照组单用化疗。卵巢癌采用PAC方案化疗,子宫体癌用MFP方案。实验时机于第2次化疗开始前至第4次化疗前,共2个月。主要观察指标:各组治疗前后血免疫功能指标及生活质量指数的变化。结果:纳入患者40例,均进入结果分析。①治疗前后Karnofsky评分值试验组分别为(84±9.6),(90±8.6)分,(P<0.05);对照组分别为(83±9.2)及(80±12.8)分,(P>0.05);治疗后试验组比对照组高10分,(P<0.05)。②治疗后试验组和对照组的CD4+分别为28.14±4.10及23.12±3.97,(P<0.05);CD4+/CD8+为0.96±0.17及0.75±0.21,(P<0.01);自然杀伤细胞为23.80±4.90,5.32±3.90,(P<0.01),试验组均明显高于对照组.结论:云芝糖肽能提高卵巢和子宫体癌患者的细胞免疫和生活质量。

BACKGROUND： The application of biological response modifiers （BRMs） has become the fourth cancer treatment following surgery, chemotherapy and radiotherapy. Polysaccharide-peptide （PSP） is a biological response modifier substance playing a special role in caucer treatment, which has been used in the treatment of gastric cancer, lung cancer, esophagual cancer, etc. with good results. OBJECTIVE： To observe the effect of PSP on the immune function and quality of life （QOL） in patients receiving chemotherapy for gynecological malignancies. DESIGN： A comparative observation. SETTING： Department of Obstetrics and Gynecology, Shanghai Jiaotong University Affiliated First People＇s Hospital. PARTICIPANTS： Forty patients who had been operated on for gynecological malignancies were selected from the Department of Obstetrics and Gynecology, Shanghai Jiaotong University Affiliated First People＇s Hospital from June 1999 to December 2002, including 36 cases of ovarian cancer with an average age of 52 years and 4 cases of endometrial cancer with an average age of 54 years. Patients with ovarian or endometrial cancer suffered from no contraindication in chemotherapy postoperatively were enrolled, otherwise were excluded. METHODS： The 4.0 patients were divided into study group （n=20） and control group （n=20） by matching according to stage and age. In the study group, the patients were treated with PSP capsules in addition to chemotherapy, whereas those in the control group were treated with chemotherap）; only. PAC （phenacetin, spirin, caffeine） and MFP （melphalan, 5-fluorouracil, medroxyprogesterone acetate） regimens were adopted for the ovarian cancers and endometrial cancer respectively. The experiment lasted for two months from the beginning of the second course of chemotherapy to the beginning of the fourth one. MAIN OUTCOME MEASURES： The indexes of blood immune function and QOL were observed before and after treatment. RESULTS： All the 4.0 patients were involved in the analysis of results.①The average Karnofkky＇s scores before and after treatment were （84±9.6） and （90±8.6） in the study group （P 〈 0.05）, and （83±9.2）, （80±12.8） in the control group （P 〉 0.05）. The average Karnofkky＇s score was 10 credits higher in the study group than in the control group （P 〈 0.05）. ②The CD4^±, CD4^±/CD8^± and natural killer cells after treatment in the study group were all obviously higher than those in the control group （28.14±4.10, 0.96±4-0.17, 23.80±4.90; 23.12±3.97, 0.75±0.21, 5.32±3.90） （P 〈 0.05, 0.01）. CONCLUSION： PSP can improve the cellular immunity and QOL of patients with ovarian or endometrial cancers.