人参皂甙Rg3联合FOLFOX4方案治疗直肠癌的疗效观察

Efficacy observation of ginsenoside Rg3 combined with FOLFOX 4 regimen for patients with carcinoma of rectum

目的观察人参皂甙Rg3联合FOLFOX 4方案治疗直肠癌根治术后患者的疗效及安全性。方法 52例直肠癌根治术后患者分为单纯化疗组(n=26)和Rg3联合组(n=26)。单纯化疗组给予FOLFOX 4方案,具体为:奥沙利铂85mg/m2静滴2h,d1;亚叶酸钙200mg/m2静滴2h,d1、d2;氟尿嘧啶400mg/m2静推,后续以600mg/m2持续静滴22h,d1、d2,每2周为1周期。Rg3联合组在给予FOLFOX 4方案基础上加服人参皂甙Rg3 40mg/d,连用2个月。采用ELISA法检测血管内皮生长因子(VEGF)的表达,并评价患者的生活质量、远期疗效和毒副反应。结果治疗后Rg3联合组患者的KPS评分为75.0±8.3,显著高于单纯化疗组的54.3±9.6(P<0.05);Rg3联合组感觉神经毒性和恶心呕吐发生率显著低于单纯化疗组(P<0.05)。治疗后Rg3联合组患者血清VEGF含量为(123.26±54.83)ng/ml,低于单纯化疗组的(256.71±78.11)ng/ml,差异有统计学意义(P<0.05)。Rg3联合组的5年生存率为61.4%,高于单纯化疗组的47.6%(P<0.05)。结论人参皂甙Rg3联合FOLFOX 4方案治疗直肠癌根治术后患者的疗效优于单纯FOLFOX 4方案,且有效改善了患者的生活质量,不良反应轻,值得进一步研究。

Objective To evaluate the efficacy and safety of ginsenoside Rg3 combined with FOLFOX 4 regimen on patients with carcinoma of rectum. Methods Fifty-two patients after radical resection of rectal carcinoma were randomly divided into two groups. FOLFOX 4 chemotherapy regimen （ L-OHP 85mg/m2 iv, dI ; CF 200mg/m2 iv, d1 -d2 ; 5-FU 400mg/m2 iv bolus firstly, then 5- FU 600mg/m2 iv,d1-d2, and two weeks was a cycle） was used in simple chemotherapy group and Rg3-combined chemotherapy group underwent Rg3 （Rg3 40mg/d po, bid）for 2 months combined with FOLFOX 4. The changes of serum VEGF levels were detected by ELISA method. The quality of life, long-term efficacy and toxicity were evaluated. Results After two-month treatment, KPS score of Rg3-combined chemotherapy group was 75.0 ± 8.3 ,which was significantly higher than that of simple chemotherapy group （ P 〈 0. 05 ）. Compared with simple chemotherapy group, toxic reactions such as sensory neurotoxicity, naupathia and vomiting were decreased in Rg3-combined chemotherapy group （P 〈 0. 05 ）. Moreover, serum VEGFs posttreatment of Rg3-combined chemotherapy group was 123.26 ± 54. 83ng/ml, which was significantly Lower than that of simple chemotherapy group （256. 71 ± 78. 11 ng/ml, P 〈 O. 05 ）. Five- year survival rate of Rg3-combined chemotherapy group was 61.4% , which was significantly higher than that of simple chemotherapy group （47.6%, P 〈 0. 05 ）. Conclusion Rg3 combined with FOLFOX 4 regimen is effective for patients with carcinoma of rectum, is superior to simple FOLFOX 4 chemotherapy, and it can improve quality of life. It may have practical clinical value and worth to study further.