FOLFOX4化疗方案对中晚期胃癌患者生活质量和免疫功能的影响

Effect of FOLFOX4 chemotherapy regimen on quality of life and immune function in patients with advanced gastric cancer

目的探讨奥沙利铂+亚叶酸钙+5-氟脲嘧啶(FOLFOX4方案)化疗对中晚期胃癌患者生活质量和免疫功能的影响。方法选取2013年1月至2018年1月间陕西省延长县人民医院收治的115例中晚期胃癌患者,采用随机数字表法分为研究组58例和对照组57例,研究组患者采用FOLFOX4方案化疗,对照组患者采用顺铂+亚叶酸钙+5-氟脲嘧啶(PLF方案)化疗,比较两组患者的临床疗效、生活质量和免疫功能。结果治疗后,研究组患者临床有效率为46.6%,对照组为42.1%,两组比较,差异无统计学意义(P>0.05)。两组患者发生的主要不良反应包括胃肠道反应、神经毒性、肾损伤、肝损伤、白细胞和血小板减少及口腔黏膜炎等,均未出现严重不良反应。其中胃肠道反应、神经毒性和口腔黏膜炎发生率研究组患者低于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者生活质量评分均下降,而研究组患者下降程度低于对照组,研究组患者CD3^+和CD4^+/CD8^+均高于对照组,差异均有统计学意义(均P<0.05)。结论中晚期胃癌患者采用FOLFOX4化疗方案,能保证临床疗效,不会增加不良反应,生活质量和免疫功能不会遭受严重损害,患者可耐受程度高。

Objective To investigate the effects of oxaliplatin plus calcium folinat and 5-fluoroura- cil （FOLFOX4） chemotherapy on quality of life and immune function in patients with advanced gastric cancer. Methods A total of 115 patients with advanced gastric cancer who admitted to Yanehang County People＇s Hospital and received chemotherapy regimens from January 2013 to February 2018 were enrolled in the study and were randomized into a study group （58 patients） and a control group （57 patients）. The study group received FOLFOX4 chemotherapy, and the control group received cisplatin plus calcium folinat and 5-fluorouracil （PLF） chemotherapy. The clinical efficacy, quality of life and immune function were compared between the two groups. Results In clinical efficiency was 46. 6% for the study group and 42. 1% for the control group （ P 〉 0. 05 ）. Adverse reactions included gastrointestinal reaction, neurotoxici- ty, kidney damage, liver damage, leukothrombopenia, haemorrhagica and oral mucositis but all patients did not have serious adverse reactions. For the incidence of gastrointestinal reaction, neurotoxicity and oral mu- cositis, the study group was lower than the control group （ all P 〈 0. 05 ）. After the treatment, the quality of life scores decreased in both grous with the decrease lower in the study group than in the control group.CD3＋ and CD4＋/CD8＋ levels was higher in the study group than in the control group （all P 〈 0. 05 ）. Conclusion For patients with advanced gastric cancer, the implementation of FOLFOX4 chemotherapy can ensure the clinical efficacy. At the same time, it will not increase the patients＇ adverse reactions without se- riously damaging quality of life and immune function and the toleraance was high.