中药三步周期疗法联合化疗治疗Ⅳ期大肠癌临床研究

Clinical Study of Applying Three-step Cycle Therapy of Chinese Herbal Medicine and Chemotherapy in the Treatment of Stage Ⅳ Colonic Cancer

目的:观察"中药三步周期疗法"联合XELOX方案化疗治疗Ⅳ期大肠癌的临床疗效。方法:53例患者,随机分为2组,对照组26例,治疗组27例。对照组:改良XELOX方案化疗(L-OHP130mg/m^2,d1;CAP1000mg/m^2,bid,d1~14;q4w×4周期);治疗组:"中药三步周期疗法"联合改良XELOX方案化疗。观察临床主要症状、生存质量、肿瘤标记物、细胞免疫功能、瘤体等指标。结果:治疗组治疗后症状总积分明显下降,优于对照组(总有效率为62.96%对19.23%,P<0.01);Karnofsky评分明显提高,优于对照组(81.11±11.55对74.23±8.57,P<0.05);CEA、CA125、CA199、CA724均明显降低,且CA199的降低优于对照组(41.78±35.95对59.23±42.72,P<0.05);CD3+、CD4+、CD4+/CD8+均明显改善,且优于对照组(分别62.04±9.49对53.42±6.31、36.07±4.88对31.15±3.17、1.50±0.20对1.29±0.27,P<0.01)。在瘤体控制上,两组无差异。结论:"中药三步周期疗法"联合改良XELOX方案治疗Ⅳ期大肠癌,能改善患者临床主要症状、提高生存质量、降低肿瘤标记物水平、改善细胞免疫功能。

Objective： To observe the clinical effect of combined chemotherapy and three- step cycle therapy of Chinese herbal medicine in treating stage Ⅳ colonic cancer. Methods： Fifty-three patients were randomly divided into two groups,26 in the controlled group and 27 in the treatment group. The chemotherapy of XELOX protocol（ L- OHP 130 mg/m^2,d1 ＋ CAP1000 mg/m^2,bid,d1~14） was given to both groups,4weeks as one cycle,and 4cycles applied in total. For patients in the treatment group,three- step cycle therapy of Chinese herbal medicine was given for 4cycles. The effects of treatment on the main symptoms,patients＇ quality of life（ QOL）,tumor markers,cell immunity function and tumor mass were observed and compared.Results： In the treatment group and the controlled group,the total effective rate was 62. 96% and 19. 23%（ P〈0. 01） on the main clinical symptoms,the Karnofsky scoring was 81. 11 ± 11. 55 and 74. 23 ± 8. 57（ P〈0. 05）,the CA199 level was 41. 78 ±35. 95 and 59. 23±42. 72（ P〈0. 05）,CD3^＋level was 62. 04 ± 9. 49 and 53. 42 ± 6. 31,CD4^＋level was 36. 07 ± 4. 88 and 31. 15 ±3. 17,and CD4^＋/CD8^＋level was 1. 50 ± 0. 20 and 1. 29 ± 0. 27（ P〈0. 01）. These data showed that the effect in the treatment group was better than that in the controlled group in terms of clinical symptom improvement,QOL,CA199 level,CD3＋level,CD4＋level,and CD4^＋/CD8^＋level. There was no difference in tumor mass between the two groups. Conclusion： Combined chemotherapy and three-step cycle therapy of Chinese herbal medicine for the treatment of stage Ⅳ colonic cancer can improve the main clinical symptoms,raise QOL,lower CA199 level and improve cell immunity function.