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吉西他滨、顺铂新辅助化疗治疗局部转移晚期膀胱癌的疗效及对抗肿瘤免疫的影响 被引量:6

Therapeutic efficacy of gemcitabine and cisplatin as neoadjuvant chemotherapy on topically metastatic advanced bladder cancer and its impact on anti-tumor immunity
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摘要 目的探讨吉西他滨、顺铂新辅助化疗治疗局部转移晚期膀胱癌的疗效及对抗肿瘤免疫的影响。方法回顾性选取2017年9月至2020年1月在本院接受治疗的局部转移晚期膀胱癌患者77例作为研究对象,根据治疗方案将其分为接受吉西他滨+顺铂(GC)化疗的GC组39例、接受甲氨蝶呤+长春花碱+阿霉素+顺铂(MVAC)化疗的MVAC组38例。比较两组患者新辅助化疗完成后的疗效及外周血中辅助性T细胞(Th)1/Th2、Th17/调节性T细胞(Treg)免疫平衡状态差异。结果新辅助化疗完成后,GC组治疗有效率显著高于MVAC组;外周血中Th1细胞比例及Th1/Th2比值高于MVAC组,Th2细胞比例低于MVAC组;外周血中Th17细胞比例及Th17/Treg比值高于MVAC组,Treg细胞比例低于MVAC组(P<0.05)。治疗期间,两组患者的药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论局部转移晚期膀胱癌患者术前接受吉西他滨、顺铂新辅助化疗,可有效提升近期疗效并优化Th1/Th2、Th17/Treg免疫平衡状态。 Objective To investigate the therapeutic efficacy of gemcitabine and cisplatin as neoadjuvant chemotherapy on topically metastatic advanced bladder cancer and its impact on anti-tumor immunity.Methods A total of 77 patients with topically metastatic advanced bladder cancer admitted to our hospital from September 2017 to January 2020 were retrospectively selected.According to the treatment scheme,they were divided into the GC group(n=39)and the MVAC group(n=38).The GC group was treated with chemotherapy of gemcitabine combined with cisplatin(GC),while the MVAC group was treated with chemotherapy of methotrexate,vinblastine,adriamycin combined with cisplatin(MVAC).The therapeutic efficacy of neoadjuvant chemotherapy and the differences in immune balance of helper T cells(Th)1/Th2 and Th17/regulatory T cells(Treg)in peripheral blood were compared between the two groups of patients.Results After neoadjuvant chemotherapy,the efficacy rate of the GC group was significantly higher than that of the MVAC group.The proportion of Th1 cells and Th1/Th2 ratio in peripheral blood were higher than those in the MVAC group,while the proportion of Th2 cells was lower than that in the MVAC group.The proportion of T h17 cells and T h17/Treg ratio in peripheral blood were higher than those in th e MVAC group,while the proportion of Treg cells was lower than that in the MVAC group(P<0.05).During the treatment,there was no statistically significant difference in the incidence of adverse drug reactions between the two groups of patients(P>0.05).Conclusion Patients with topically metastatic advanced bladder cancer treated with neoadjuvant chemotherapy of gemcitabine combined with cisplatin before operation can effectively improve the short-term therapeutic efficacy and optimize the immune balance of Th1/Th2 and Th17/Treg.
作者 沈德彬 邱树胜 苏秀玲 SHEN Debin;QIU Shusheng;SU Xiuling(Department of Pharmacy,the Second Hospital of Longyan,Fujian,Longyan 364000,China)
出处 《中国医药科学》 2021年第8期41-44,47,共5页 China Medicine And Pharmacy
关键词 局部转移晚期膀胱癌 吉西他滨 新辅助化疗 抗肿瘤免疫 Topically metastatic advanced bladder cancer Gemcitabine Neoadjuvant chemotherapy Anti-tumor immunity
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