紫杉醇联合复方苦参注射液同步放化疗对食管癌老年患者的近期疗效及毒副作用

Concurrent Chemoradiotherapy of Paclitaxel Combined with Compound Kushen Injection Treating Elderly Patients with Esophagus Cancer: Analysis of Short-term Efficacy and Toxic and Side Effects

目的:分析紫杉醇联合复方苦参注射液同步放化疗对食管癌老年患者的近期疗效及毒副作用。方法:选取于本院诊治的食管癌老年患者118例,随机分为观察组与对照组,各59例。对照组采用紫杉醇同步放化疗,观察组在对照组的基础上静脉注射复方苦参注射液至放化疗结束,放化疗时间共计3个月,随访1年。比较2组患者近期临床疗效、治疗前后免疫功能变化、治疗及随访期间毒副反应发生情况。结果:治疗3个月后观察组DCR(96.61%)显著高于对照组(67.80%)(P<0.05);随访期结束后观察组生存率(86.44%)显著高于对照组(67.80%)(P<0.05);治疗后观察组全血CD_4^+比例、CD_4^+/CD_8^+显著高于治疗前及对照组,全血CD_8^+比例显著低于治疗前及对照组(P<0.01);治疗后对照组血清IgG、IgA及IgM水平显著低于治疗前及观察组(P<0.01);治疗及随访期间观察组Ⅰ~Ⅱ级食欲下降、呕吐、白细胞下降、放射性食管炎及Ⅲ~Ⅳ级呕吐的发生率均显著低于对照组(P<0.05)。结论:紫杉醇联合复方苦参注射液同步放化疗治疗老年食管癌有效控制病情进展,降低毒副反应,提升患者对治疗的耐受性及生存率。

Objective: To analyze the short-term efficacy and toxic and side effects of concurrent chemoradiotherapy of Paclitaxel( PTX) combined with compound Kushen injection treating elderly patients with esophagus cancer. Methods:118 elderly patients with esophagus cancer were randomly divided into the observation group( n = 59) and the control group( n = 59). The control group was treated with concurrent chemoradiotherapy of PTX; on which basis,the observation group was also treated with compound Kushen injection to the end of chemoradiotherapy. The chemoradiotherapy was three months,and the follow-up was one year. The short-term clinical efficacy was compared between the two groups; immune function changes before and after the treatment,as well as the toxic and side effects during the follow-up were observed. Results: After three-month treatment,DCR was 96. 61% in the observation group,which was significantly higher than 67. 80% in the control group( P < 0. 05); during the follow-up,the survival rate was 86. 44% in the observation group,which was also significantly higher than 67. 80% in the control group( P < 0. 05). The blood CD_4^+ ratio and CD_4^+/CD_8^+ were significantly higher after the treatment than those before the treatment in the theatment group; they were much higher in the observation group compared to those in the control group( P < 0. 01); the blood CD_8^+ ratio after the treatment in the observation group was significantly lower than that before the treatment and that in the control group( P < 0. 01). The serum levels of IgG,IgA and IgM were significantly lower in the control group after the treatment than those before the treatment and those in the observation group( P < 0. 01). During the treatment and follow-up period,the toxic and side effects,such as the incidence rates of grade I ~ II appetite,vomiting,white blood cell descent,radiation esophagitis and grade III ~ IV vomiting,were remarkably lower in the observation group than those in the control group( P < 0. 05). Conclusion: Concurrent chemoradiotherapy of PTX combined with compound Kushen injection can effectively control the progress of esophagus cancer in elderly patients,reduce the toxic and side effects,and increase the tolerance and improve survival rate.