DCF方案和FOLFOX4方案治疗晚期胃癌及外周血淋巴细胞表型的对比研究

Efficacy of DCF regimen and FOLFOX4 regimen in the treatment of late gastric cancer and its effect on phenotypic changes of peripheral blood lymphocytes:a comparative study

目的探讨采用多西他赛、顺铂、氟尿嘧啶(docetaxel、cisplatin、5-FU,DCF)方案与奥沙利铂、氟尿嘧啶、亚叶酸钙(L-OHP、5-FU、LV,FOLFOX4)方案治疗晚期胃癌的疗效,对比研究外周血淋巴细胞表型变化。方法收集2014年6月至2017年6月青海省人民医院收治的84例晚期胃癌患者临床资料,根据化疗方案不同分组,分别为DCF组44例,FOLFOX4组40例。两组均连续治疗两个疗程,比较短期临床疗效、外周血淋巴细胞表型水平变化、不良反应发生情况及癌症Karnofsk生活质量评分(KPS)与癌症疼痛评分(NRS)。结果 DCF组治疗有效率为59.09%,高于FOLFOX4组(45.00%),差异有统计学意义(P<0.05)。两组治疗后血清CD4+水平、CD4+/CD8+均显著升高,DCF组高于FOLFOX4组,差异有统计学意义(P<0.05),治疗前后血清CD3+、CD8+组间、组内比较差异无统计学意义(P>0.05)。DCF组消化道反应、外周神经炎轻于FOLFOX4组,差异有统计学意义(P<0.05);脱发、白细胞减少、血小板减少等差异无统计学意义(P>0.05)。治疗前后KPS评分与NRS评分差异有统计学意义,治疗后DCF组优于FOLFOX4组,差异有统计学意义(P<0.05)。结论晚期胃癌采用DCF方案治疗短期疗效更优,能提高抗肿瘤免疫功能,降低不良反应,缓解癌痛,提高患者生活质量。

Objective Comparethe the effect of Docetaxel＋Cisplatin＋Fluorouracil regimen and Oxaliplatin＋Fluorouracil＋Calcium folate regimen in the treatment of late gastric cancer and its effect on phenotypic changes of peripheral blood lymphocytes.Methods In this study,84 patients with late gastric cancer treated in our hospital from June 2014 to June 2017 were enrolled and divided into groups according to the chemotherapy regimen.Forty-Four patients who underwent DCF regimen were included into the DCF group,and 40 patients underwent FOLFOX4 regimen were included into the FOLFOX4 group,both treated for two courses.Then the short-term clinical efficacy,changes in peripheral blood lymphocyte phenotypes,incidence of adverse reactions,KPS score and NRS score of the two groups were compared.Results The effective rate of the DCF group was 59.09%,which was significantly higher than that of the FOLFOX4 group（45.00%）,the difference was statistically significant（P〈0.05）.The levels of CD4^＋and CD4^＋/CD8^＋in the two groups were significantly increased after treatment,and the mentioned levels in the DCF group were significantly higher than those of the FOLFOX4 group（P 〈 0.05）;The levels of CD3^＋and CD8^＋within group or between groups before and after treatment had no significant difference（P〉0.05）.The DCF group＇s digestive tract reaction and peripheral neuritis were lighter in the DCF group than in the FOLFOX4 group,the difference was statistically significant（P〈0.05）.No significant difference was found in alopecia,leucocyte reduction and thrombocytopenia（P〉0.05）.There was a significant difference between the KPS score and the NRS score before and after the treatment,and the scores of the DCFgroup were better than those of the FOLFOX4 group,with statistic difference（P〈0.05）.Conclusions Compared with the FOLFOX4 regimen,DCF regimenhas a better short-termefficacy in the treatment oflategastric cancer,which can improve the anti tumor immune function,reduce the adverse reaction,alleviate the cancer pain and improve the patient＇s quality of life.