甲孕酮改善晚期肿瘤病人化疗期生活质量

Combination chemotherapy with medroxyprogesterone acetate to improve quality of life in patients with advanced malignant tumor

目的 观察病人服用甲孕酮后改善化疗引起的厌食、体重下降、Kps评分下降、骨髓抑制及胃肠道反应的作用。方法 117例接受化疗的晚期肿瘤患者 ,采用单盲随机分成化疗 +甲孕酮组共 5 8例 ,单用化疗组 5 9例作为对照。结果 在化疗 +甲孕酮治疗的 15 6个周期中有 5 5 .1%食量增加 ;42 .3 %体重增加 ;平均每周期体重增加 1.46± 0 .82kg ;血浆白蛋白升高 2 .1± 3 .3 0 g/L ;2 6.9%Kps评分改善。按WHO抗癌药物急性毒性分级标准 ,3 1.4%出现Ⅱ度以上的白细胞下降、血红蛋白下降 2 3 .7%、胃肠道反应 17.9% ,平均恢复时间分别为 5 .8± 5 .5天、5 .9± 3 .8天及 1.8± 1.4天。上述各项指标与对照组比较均有显著性差异。结论 甲孕酮如能正确合理地应用于晚期肿瘤病人的辅助治疗 ,可以全面改善化疗期癌症患者的生活质量。

Objective To investigate the effect of medroxyprogesterone acetate (MPA) on anorexia,weight loss,Karnofsky′s score,myelosuppression as well as nausea and vomiting caused by chemotherapy.Methods 117 patients with advanced malignant tumor treated with chemotherapy(CT) were randomly divided into two groups:58 cases were treated with chemotherapy and MPA,and the other 59 cases with chemotherapy alone as control.Results The results showed that the patients who were given 156 cycles of MPA and CT had increasing intake of food (55.1%),weight gain(42.3%) with every cycle 1.46±0.82kg,blood albumin rising to 2.1±3.30g/L in average and Karnofsky′s score improvement in 26.9%.According to WHO criteria of side effect of chemotherapy,31.4% presented grade Ⅱ or more leukopenia,and the levels of hemoglobin were decreased in 23.7% and gastrointestinal irritation in 17.9%,the mean recovery time being 5.8±5.5,5.9±3.8 and 1.8±1.4 days respectively.As compared with the control group,it showed significant statistical differences.Conclusion Reasonable use of MPA can improve the life quality of patients with advanced malignant tumor in chemotherapy.