阿帕替尼联合吉西他滨对晚期胰腺癌患者免疫功能和生活质量的影响

Effects of Apatinib Combined with Gemcitabine on Immune Function and Quality of Life in Patients with Advanced Pancreatic Cancer

目的:探究在晚期胰腺癌(PC)患者中应用阿帕替尼与吉西他滨联合治疗,对患者免疫功能、生活质量等的影响。方法:随机选取常熟市第一人民医院肿瘤科2019年1月—2021年6月收治的112例晚期PC患者作为本次研究对象,用随机数字表法将其分为两组,每组56例。对照组予以吉西他滨治疗,联合组予以吉西他滨与阿帕替尼联合治疗。比较两组近远期疗效、肿瘤标志物及免疫功能水平、生活质量、不良反应发生情况。结果:联合组近期总缓解率明显优于对照组(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)/CD8^(+)水平差异均无统计学意义(P>0.05);治疗后,两组CD3^(+)、CD4^(+)/CD8^(+)水平均较治疗前明显上升(P<0.05),联合组均明显高于对照组(P<0.05)。治疗前,两组癌胚抗原(CEA)、糖类抗原19-9(CA19-9)水平差异均无统计学意义(P>0.05);治疗后,两组CEA、CA19-9水平较治疗前均明显下降(P<0.05),联合组均明显低于对照组(P<0.05)。治疗前,两组癌症患者生命质量测定量表(QLQ-C30)评分差异无统计学意义(P>0.05);治疗后,两组QLQ-C30评分较治疗前均明显上升(P<0.05),联合组明显高于对照组(P<0.05)。两组药物不良反应发生率比较差异无统计学意义(P>0.05)。联合组复发率明显低于对照组(P<0.05);两组死亡率差异无统计学意义(P>0.05)。结论:对晚期PC患者应用吉西他滨与阿帕替尼联合治疗,患者近远期疗效、免疫功能、生存质量有明显提升,肿瘤标志物水平明显下降,且用药安全性较高,有较好临床应用价值。

Objective:To investigate the effects of Apatinib combined with Gemcitabine on immune function,quality of life and so on in patients with advanced pancreatic cancer(PC).Method:A total of 112 patients with advanced PC who were admitted to the Department of Oncology of Changshu First People's Hospital from January 2019 to June 2021 were randomly selected for this study,and all of them were divided into two groups with 56 cases in each group by random number table method.The control group was treated with Gemcitabine,the combination group was treated with Gemcitabine plus Apatinib.The short-term and long-term therapeutic effects,the levels of tumor markers and immune function,quality of life and occurrence of adverse effects were compared between the two groups.Result:The short-term total remission rate of the combination group was significantly better than that of the control group(P<0.05).Before treatment,there were no significant differences in the levels of CD3^(+),CD4^(+)/CD8^(+)between the two groups(P>0.05).After treatment,the levels of CD3^(+),CD4^(+)/CD8^(+)in both groups increased significantly compared with before treatment(P<0.05),and those in the combination group were significantly higher than those in the control group(P<0.05).Before treatment,the levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)were not significantly different between the two groups(P>0.05).After treatment,the levels of CEA and CA19-9 in both groups decreased significantly compared with those before treatment(P<0.05),and those in the combination group were significantly lower than those in the control group(P<0.05).Before treatment,the quality of life measurement scale(QLQ-C30)scores of cancer patients were not significantly different between the two groups(P>0.05).After treatment,QLQ-C30 scores increased significantly in both groups compared with before treatment(P<0.05),and that in the combination group was significantly higher than that in the control group(P<0.05).There was no significant difference in incidence of adverse drug reactions between the two groups(P>0.05).The recurrence rate was significantly lower in the combination group than that in the control group(P<0.05).There was no significant difference in mortality between the two groups(P>0.05).Conclusion:The application of Gemcitabine combined with Apatinib in the treatment of patients with advanced PC can significantly improve the short-term and long-term efficacy,immune function and quality of life of patients,the levels of tumor markers are significantly decreased,and the drug safety is high,which has good clinical application value.