放疗同步FOLFIRINOX化疗对晚期胰腺癌患者免疫功能及CYFRA21-1、SCC的影响

Effects of Radiotherapy Combined with FOLFIRINOX Chemotherapy on Immune Function and Levels of CYFRA21-1 and SCC inPatients with Advanced Pancreatic Cancer

目的探讨放疗同步FOLFIRINOX化疗对晚期胰腺癌患者免疫功能及角蛋白19片段抗原21-1(CYFRA21-1)、鳞状上皮细胞癌抗原(SCC)的影响。方法选取2015年6月至2016年6月本院收治的92例晚期胰腺癌患者为研究对象,将其按数字表分为观察组与对照组,每组46例。对照组采用单纯的放疗治疗,观察组患者采用放疗同步FOLFIRINOX化疗治疗。对两组患者的近期疗效、治疗前后的免疫功能指标、CYFRA21-1、SCC水平、远期疗效、不良反应发生率等进行统计分析。结果观察组总有效率89.13%(41/46),显著高于对照组63.04%(29/46)(P<0.05)。治疗后观察组CD3^+、CD4^+细胞阳性率、CD4^+/CD8^+比值均高于对照组,而CD8^+细胞阳性率则低于对照组(P<0.05),且观察组血清恶性生物学指标CYFRA21-1、SCC水平均明显低于对照组(P<0.05)。2组患者经过为期3年的门诊随访,观察组的局部复发率、远端转移瘤、死亡率均显著低于对照组,无病生存率明显高于对照组(P<0.05)。治疗期间观察组、对照组不良反应发生率分别为23.91%(11/46)、15.22%(7/46),组间比较无明显差异(P>0.05)。结论对晚期胰腺癌患者实施放疗同步FOLFIRINOX化疗治疗,能提高患者的疾病缓解率和远期生存率,并且能够降低患者的血清肿瘤标志物水平,对免疫功能的影响较小,降低患者的复发率和死亡率,治疗安全性较好,值得临床推广。

Objective To investigate the effects of radiotherapy combined with FOLFIRINOX chemotherapy on immune function,as well as keratin 19 fragment antigen 21-1(CYFRA21-1)and squamous cell carcinoma antigen(SCC)in patients with advanced pancreatic cancer.Methods 92 patients with advanced pancreatic cancer admitted to our hospital from June,2015 to June,2016 were selected as the subjects for the current study.They were randomly divided into the observation group and the control group with 46 cases in each group by the digital table method.The control group was treated with radiotherapy alone,while the observation group was treated with radiotherapy combined with FOLFIRINOX chemotherapy.The short-term efficacy,immune function index,CYFRA21-1 and SCC levels,long-term efficacy and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 89.13%(41/46),which was higher than that of the control group with 63.04%(29/46)(P<0.05).After the treatment,the positive rate of CD3^+,CD4^+cells and the ratio of CD4^+/CD8^+in the observation group were higher than those in the control group,while the positive rate of CD8^+cells in the observation group was lower than that in the control group(P<0.05).After the treatment,the serum levels of CYFRA21-1 and SCC in the observation group were lower than those in the control group(P<0.05).After 3 years of follow-up,the local recurrence rate,distal metastasis rate and mortality rate in the observation group were lower than those in the control group,and the disease-free survival rate was higher than that in the control group(P<0.05).During the treatment period,the incidence of adverse reactions in the observation group and the control group were 23.91%(11/46)and 15.22%(7/46),respectively,with no significant difference(P>0.05).Conclusion Radiotherapy combined with FOLFIRINOX chemotherapy for patients with advanced pancreatic cancer can improve the disease remission rate and long-term survival rate,also reduce the level of serum tumor markers,improve the immune function,reduce the recurrence rate and mortality rate.The treatment is safe and worthy of clinical promotion.