乌苯美司联合卡培他滨和洛铂治疗转移性乳腺癌的临床研究

Clinical study on ubenimex combined with capecitabine and lovastatin in treatment of metastatic breast cancer

目的探讨乌苯美司胶囊联合卡培他滨片和注射用洛铂治疗转移性乳腺癌的临床疗效。方法选取2015年3月—2018年3月在开封市肿瘤医院治疗的转移性乳腺癌患者78例,根据用药方案的差别分为对照组(39例)和治疗组(39例)。对照组静脉滴注注射用洛铂,50 mg/m^2加入5%葡萄糖注射液250 mL,1次/d,3周为1个疗程,同时口服卡培他滨片,1.0 g/次,2次/d,连续服用2周,停1周,3周为1个疗程;治疗组在对照组基础上口服乌苯美司胶囊,10 mg/次,3次/d。两组患者均连续治疗两个疗程。观察两组患者临床疗效,同时比较治疗前后两组患者肿瘤标志物水平、血管内皮生长因子水平、生活质量评分和T淋巴细胞亚群水平。结果治疗后,对照组客观缓解率和临床获益率分别为43.59%、71.79%,均分别显著低于治疗组的69.23%、87.18%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清血清癌胚抗原(CEA)、糖蛋白125(CA125)、糖蛋白153(CA153)、糖蛋白199(CA199)、血管内皮生长因子-A(VEGF-A)、血管内皮生长因子-C(VEGF-C)、血管内皮生长因子受体-3(VEGFR-3)水平均显著降低(P<0.05),且治疗组这些指标水平明显低于对照组(P<0.05)。治疗后,两组QLQ-C30和FACT-B量表评分明显升高(P<0.05),且治疗组生活质量评分明显高于对照组(P<0.05)。治疗后,两组血清CD3^+、CD4^+、CD4^+/CD8^+水平均显著升高(P<0.05),CD8^+水平显著降低(P<0.05),且治疗组T淋巴细胞亚群水平明显好于对照组(P<0.05)。结论乌苯美司胶囊联合卡培他滨片和注射用洛铂治疗转移性乳腺癌能够显著降低机体肿瘤标志物水平,提高免疫功能,促进患者生活质量提高。

Objective To investigate the clinical efficacy of ubenimex combined with capecitabine and lovastatin in treatment of metastatic breast cancer.Methods Patients (78 cases) with metastatic breast cancer in Kaifeng Cancer Hospital from March 2015 to March 2018 were divided into control (39 cases) and treatment (39 cases) groups based on different treatments.Patients in the control group were iv administered with Lobaplatin for injection,50 mg/m^2 added into 5% glucose injection 250 mL,once daily.At the same time they were po administered with Capecitabine Tablets,1 g/time,twice daily,continuous administered for 2 weeks,and stop for 1 week,3 weeks as a course of treatment.Patients in the treatment group were po administered with Ubenimex Capsules on the basis of the control group,10 mg/time,three times daily.Patients in two groups were treated for 2 courses of treatment.After treatment,the clinical efficacy was evaluated,and the tumor markers levels,the vascular endothelial growth factor levels,the quality of life and the levels of T lymphocyte subsets in two groups before and after treatment were compared.Results After treatment,the objective reaction rate and clinical benefit rate in the control group were 43.59% and 71.79%,which were significantly lower than 69.23% and 87.18% in the treatment group,respectively,and there were differences between two groups (P < 0.05).After treatment,the serum CEA,CA125,CA153,CA199,VEGF-A,VEGF-C,and VEGFR-3 levels in two groups were significantly decreased (P < 0.05),and these indexes levels in the treatment group were significantly lower than those in the control group (P < 0.05).After treatment,the QLQ-C30 and FACT-B scores in two groups were significantly increased (P < 0.05),and these scores in the treatment group were significantly higher than those in the control group (P < 0.05).After treatment,the serum CD3^+,CD4^+,CD4^+/CD8^+ levels in two groups were significantly increased (P < 0.05),but CD8^+ were significantly decreased (P < 0.05),and the levels of T lymphocyte subsets in the treatment group were significantly better than those in the control group (P < 0.05).Conclusion Ubenimex combined with capecitabine and lovastatin can significantly reduce the level of tumor markers in treatment of metastatic breast cancer,improve the immune function and promote the quality of life.