鸦胆子油乳联合常规化疗方案对局部晚期膀胱癌患者的疗效观察及免疫功能的影响

Effect of brucea javanica oil emulsion combined with routine chemotherapy on patients with locally advanced bladder cancer and immune function

目的探究鸦胆子油乳联合常规吉西他滨+顺铂(Gemcitabine+Cisplatin,GP)化疗方案治疗不可手术的局部晚期膀胱癌患者的疗效,并观察其对免疫功能的影响。方法选取大连医科大学附属第二医院收治的中晚期膀胱患者80例,按随机数表法分为对照组和治疗组,各40例。两组均给予常规GP化疗,对照组在化疗的同时静脉滴注灭菌注射用水,治疗组静脉滴注等量鸦胆子油乳,3周为1个治疗周期,两组均连续治疗4个周期。对比两组临床疗效、生活质量、免疫功能及不良反应。结果与治疗前比较,治疗1～4个周期后,对照组卡氏评分(KPS)先减低后升高,治疗组KPS评分逐渐升高,且治疗1、2、4个周期治疗组高于对照组,差异有统计学意义(P <0.05);与治疗前比较,治疗后对照组全血T淋巴细胞(CD_3^+)、辅助性T细胞(CD_4^+)、自然杀伤细胞(NK)比例及CD_4^+/CD_8^+值降低,全血CD_8^+升高,差异有统计学意义(P <0.05);治疗组全血CD_3^+、CD_4^+、NK比例及CD_4^+/CD_8^+值升高,且高于对照组,全血CD_8^+比例降低,且低于对照组,差异均有统计学意义(P <0.05);治疗组总不良反应发生率低于对照组,差异有统计学意义(P <0.05);随访2年后治疗组无进展生存期、生存率、中位生存时间与对照组比较,差异均有统计学意义(P <0.05)。结论鸦胆子油乳联合常规GP化疗方案可提高不可手术的局部晚期膀胱癌患者免疫功能,改善生活质量,降低化疗所致的不良反应,且疗效显著优于单独常规GP化疗。

Objective To study the efficacy of brucea javanica oil emulsion combined with conventional Gemcitabine+Cisplatin(GP)chemotherapy regimens in the treatment of patients with local advanced bladder cancer who could not be operated and to study its effect on immune function.Methods 80 cases patients with advanced bladder cancer were selected in our hospital and divided into the Control Group and the Treatment Group according to random number table method,with 40 cases in each group.The patients in both groups received routine GP chemotherapy,while the patients in Control Group were dripped intravenously with sterilised water,and the patients in Treatment Group were dripped intravenously with the same mount of brucea javanica oil emulsion.One treatment cycle was 3 weeks.All the patients in both groups received 4 treatment cycles.The clinical curative effect,life quality,immune function and toxic and side effects in the two groups were compared.Results During the treatment period,the KPS score in the Control Group decreased first and then increased,and the KPS score in the Treatment Group increased gradually from 1 to 4 cycles of treatment.And the KPS score in the Treatment Group was higher than that in the Control Group after 1,2,4 cycles of treatment(P<0.05)In the Control Group,compared with before treatment,the CD3^+,CD4^+,NK proportion and the CD4^+/CD8^+value in the whole blood of the control group decreased and the CD8^+proportion increased after treatment,there was significant difference between them(P<0.05).In the Treatment Group,the CD3^+,CD4^+,NK proportion and the CD4^+/CD8^+value in the whole blood of were higher than those in the Control Group(all P<0.05).The total incidence of toxic and side effects in theTtreatment group was lower than that in the Control group,there was significant difference between the two group(P<0.05).After 2 years of follow-up,the progression-free survival,survival rate and median survival time in the Treatment group were longer/higher/longer than those in the Control Group(all P<0.05).Conclusion Brucea javanica oil emulsion combined with conventional GP chemotherapy regimens can enhance immune function of non-surgical local advanced bladder cancer,improve life quality and reduce toxic and side effects caused by chemotherapy,and the efficacy is significantly better than that of conventional GP chemotherapy alone.