单药多西他赛与多西他赛联合顺铂治疗胸腺瘤合并重症肌无力的临床疗效研究

Clinical Efficacy of Docetaxel Alone Versus Docetaxel Combined with Cisplatin in the Treatment of Thymoma with Myasthenia Gravis

目的探讨单药多西他赛与多西他赛联合顺铂治疗胸腺瘤合并重症肌无力(MG)的临床疗效,以期为临床医生提供新的治疗思路。方法选取2008年1月—2015年12月就诊于石家庄市第一医院的明确诊断为胸腺瘤合并MG患者106例。2008年1月—2015年1月应用多西他赛联合顺铂治疗的胸腺瘤合并MG患者(DP组)66例,包括20例胸腺瘤术后出现转移胸腺瘤患者;2012年1月—2015年12月应用单药多西他赛治疗胸腺瘤合并MG患者(D组)40例,包括17例胸腺瘤术后出现转移胸腺瘤患者。两组分别给予相应药物治疗,比较两组患者治疗前后临床绝对评分、乙酰胆碱受体抗体(AchRAb)、MG临床疗效、毒副作用发生情况。结果两组治疗前临床绝对评分、AchRAb比较,差异无统计学意义(P>0.05)。两组治疗后临床绝对评分、AchRAb比较,差异无统计学意义(P>0.05)。两组治疗后临床绝对评分、AchRAb低于治疗前(P<0.05)。两组MG临床疗效比较,差异无统计学意义(P>0.05)。DP组患者毒副作用发生率高于D组(P<0.05)。结论单药多西他赛与多西他赛联合顺铂治疗胸腺瘤合并MG患者的疗效无差异,但单药多西他赛的毒副作用小。

Objective To investigate the clinical efficacy of docetaxel alone versus docetaxel combined with cisplatin in the treatment of thymoma with myasthenia gravis （ MG）, with a view to providing new treatment ideas for clinicians. Methods We enrolled 106 patients who were diagnosed with thymoma and MG and received treatment in the First Hospital of Shijiazhuang from January 2008 to December 2015 and divided them into two groups, group DP （66 cases including 20 with metastatic thymoma after thymoma surgery ） receiving docetaxel combined with cisplatin between January 2008 and January 2015, and group D （40 cases including 17 with metastatic thymoma after thymoma surgery ） receiving docetaxel alone between January 2012 and December 2015. The clinical absolute score was assessed and acetylcholine receptor antibody （ AchRAb ） level was measured before and after treatment. The clinical efficacy of MG and toxic side effects were observed. Results Before treatment, both groups showed similar clinical absolute scores and AchRAb levels （ P 〉 0. 05 ） ; after treatment, they still presented similar clinical absolute scores and AchRAb levels （ P 〉 0. 05 ） . After treatment, the chnical absolute scores and AchRAb levels decreased significantly in group DP as well as group D （ P 〈 0. 05 ） . The effect of treatment for MG did not differ significantly between the groups （ P 〉 0. 05 ） . The incidence of toxic side effects in group DP was higher than that in group D （ P 〈 0. 05 ）. Conclusion For thymoma with MG, docetaxel alone and docetaxel combined with cisplatin can achieve similar clinical efficacy, but docetaxel has less side effects.