热化疗对Ⅳ期结直肠癌患者临床疗效和免疫功能的影响

Effects of hyperthermia chemotherapy on clinical efficacy and immune function in patients with stage Ⅳ colorectal cancer

目的:探讨热化疗对Ⅳ期结直肠癌患者临床疗效和免疫功能的影响。方法:连续性纳入自2015年1月至2016年12月我院所收治的Ⅳ期结直肠癌110例,随机分为研究组及对照组,每组各55例。对照组给予单纯静脉化疗,研究组在此基础上联合热疗治疗。比较两组在近期疗效、外周血淋巴细胞、血清肿瘤标记物、毒副反应以及生命质量之间的差异。结果:根据RECIST1. 1实体瘤疗效评估法对两组近期疗效进行评估,研究组客观有效率(P=0. 001)及疾病控制率(P=0. 007)均显著性优于对照组。外周血淋巴细胞方面,治疗后研究组外周血CD4^+T细胞明显升高(P=0. 000);CD4^+/CD8^+T细胞比例显著升高(P=0. 002),明显优于对照组。血清肿瘤标记物方面,治疗后研究组血清癌胚抗原(CEA),糖类蛋白19-9(CA19-9),糖类抗原125(CA125)均显著性低于对照组,差异具有统计学意义(P<0. 05)。毒副反应方面,两组毒副反应未见统计学差异(P>0. 05)。生命质量方面,研究组在功能维度中的体力功能(P=0. 009)、情感功能(P=0. 015)以及社会功能(P=0. 000)评分明显高于于对照组;在症状维度中的疲劳(P=0. 010)、疼痛(P=0. 000)、便秘(P=0. 001)评分明显低于对照组;研究组综合生命质量评分明显优于对照组(P=0. 002)。结论:热化疗可以有效提高Ⅳ期结直肠患者的近期疗效,改善患者免疫功能和生命质量,且不增加患者风险。

Objective:To investigate the effect of hyperthermia chemotherapy on the clinical efficacy and immune function in patients with stageⅣcolorectal cancer.Methods:110 cases of stageⅣcolorectal cancer were continuously collected from January 2015 to December 2016,and were randomly divided into a study group and a control group,each group with 55 cases.The control group were treated with simple intravenous chemotherapy,while the group were combined with hyperthermia chemotherapy.Differences in short-term effects peripheral blood lymphocytes,serum tumor markers,toxic reactions and the quality of life were compared between two groups.Results:According to RECIST1.1 solid tumor efficacy evaluation criteria,the study group showed significantly better objectively efficacy(P=0.001)and the disease control rate(P=0.007).In the aspect of peripheral blood lymphocytes,the CD4+T cells were significantly increased after treatment(P=0.000);and the ratio of CD4+/CD8+T cells increased significantly(P=0.002)in the study group,significantly better than the control group.In the aspect of serum tumor markers,after treatment serum carcinoembryonic antigen(CEA)and carbohydrate protein 19-9(CA19-9),carbohydrate antigen 125(CA125),as well as the level of tissue polypeptide specific antigen(TPS)in the study group were significantly lower than the control group(P<0.05).There was no statistical difference between the two groups in the aspect of adverse reactions(P>0.05).In the aspect of quality of life,functional dimension(P=0.009),emotional function(P=0.015)and social function(P=0.000)in the study group were significantly better than the control group.In symptom dimension,fatigue(P=0.010),pain(P=0.000)and constipation(P=0.001)score in the study group were significantly lower than the control group.The comprehensive life quality score in the study group was significantly better than that of the control group(P=0.002).Conclusion:Hyperthermia chemotherapy can effectively improve the short-term efficacy,improve the immune function and quality of life,without increasing the risk in stageⅣcolorectal patients.