老年尿路上皮肿瘤患者经吉西他滨辅助化疗后生存率状况研究

Study on the survival rate after gemcitabine chemotherapy in elderly patients with urothlial tumor

目的探讨老年尿路上皮肿瘤患者经吉西他滨辅助化疗后的生存率状况。方法选取经尿路上皮肿瘤术后病理学确诊42例老年尿路上皮肿瘤患者,随机分为两组,每组21例。化疗前均给予5HT3受体拮抗剂及地塞米松,对照组给予紫杉醇联合奥沙利铂方案,研究组予吉西他滨联合奥沙利铂方案,均28 d 1个疗程,连续治疗3个疗程。检测外周血T细胞亚群和肿瘤相关标志物水平,评估生活质量,长期随访并详细记录存活时间,比较治疗效果和生存率。结果与治疗前比较,两组外周血CD3^+、CD4^+及CD4^+/CD8^+降低(P<0.05),CD8^+升高(P<0.05),血清肿瘤标志物CYFRA211、NSE、CEA及CA125降低(P<0.01),食欲、精神、睡眠以及疲乏评分降低(P<0.05),KPS评分升高(P<0.05);与对照组比较,研究组CD3^+、CD4^+及CD4^+/CD8^+较高(P<0.05),CD8^+较低(P<0.05),血清肿瘤标志物CYFRA211、NSE、CEA及CA125较低(P<0.01),食欲、精神、睡眠以及疲乏评分较高(P<0.05),KPS评分较高(P<0.05),有效率较高(P<0.05),随访生存率较高(P<0.05)。结论吉西他滨辅助化疗能提高老年尿路上皮肿瘤患者生活质量,延长存活时间。

Objective To investigate the survival rate of elderly patients with urothelial tumor after gemcitabine chemotherapy. Methods 42 elderly patients with urothelial tumors who were pathologically diagnosed after the surgery of urothelial tumors were selected and randomly divided into two groups, with 21 patients in each group.The, patients were given 5HT3 receptor antagonist and dexamethasone before chemotherapy. The control group was given the regimen of paclitaxel combined with oxaliplatin,and the study group was given the regimen of gemcitabine combined with oxali- platin, with 28 days as a course of treatment for 3 continuous courses. Peripheral blood T cell subsets and tumor-asso- ciated markers were detected. The quality of life was evaluated,the patients were given long-term follow-up and de- tailed survival time was recorded. The therapeutic effect and survival rate were compared. Results CD3＋, CD4＋ and CD4＋/CD8＋ in peripheral blood were decreased compared with those before the treatment, and CD8＋ was increased （P〈0.05）. Serum tumor markers CYFRA211, NSE, CEA and CA125 were decreased（P〈0.01）. Appetite, spirit, sleep and fatigue scores were reduced （P〈0.05）. KPS score was increased（P〈0.05）; compared with the control group, CD3＋, CD4＋ and CD4＋/CD8＋ were higher in the study group（P〈0.05）, and CD8＋ was lower（P〈0.05）. Serum tumor markers CYFRA211, NSE, CEA and CA125 were lower （P〈0.01）. The scores of appetite, spirit, sleep and fatigue were higher （P〈0.05）. KPS score was higher（P〈0.05）. The efficiency was higher（P〈0.05）, and the follow-up survival rate was higher（P〈0.05）. Con- clusion Adjuvant chemotherapy by gemcitabine can improve the quality of life of elderly patients with urothelial tumor and prolong the survival time.