复方红豆杉胶囊联合微波消融术在早期非小细胞肺癌治疗中的应用及对预后的影响

Application of compound Taxus capsule combined with microwave ablation in treatment of early non-small cell lung cancer and its effect on prognosis

目的观察复方红豆杉胶囊联合微波消融术(microwave ablation,MWA)治疗早期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效。方法收集2017年1月—2019年1月在郑州人民医院就诊的Ⅰ期NSCLC患者80例,按照随机数字表法分为对照组(n=40)和观察组(n=40),对照组接受MWA治疗,观察组在MWA术后口服复方红豆杉胶囊;分析比较两组患者术后3个月短期疗效、不良反应及免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))差异,随访比较两组无复发生存期(recurrence-free survival,RFS)和总生存期(over-all survival,OS)情况,采用COX回归方法分析治疗方式与患者预后生存的相关性。结果观察组与对照组术后3个月疗效及不良反应率无统计学差异(P>0.05),但CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)均明显高于对照组(均P<0.05);观察组RFS显著高于对照组(χ^(2)=5.131,P=0.024),但其OS与对照组间无统计学差异(χ^(2)=1.907,P=0.167);复方红豆杉胶囊联合MWA治疗方式是RFS的独立保护因素(OR=0.309,95%CI=0.099~0.960,P=0.042),但其不是OS的独立影响因素(P>0.05)。结论复方红豆杉胶囊联合MWA可在一定程度上改善早期NSCLC患者的免疫功能及预后,具有临床推广意义。

Objective To investigate the clinical efficacy of compound Taxus capsule combined with microwave abla-tion(MWA)in the treatment of early non-small cell lung cancer(NSCLC).Methods Totally 80 patients who were diagnosed as non-small cell lung cancerⅠstage from January 2017 to January 2019 in People's Hospital of Zhengzhou were collected and randomly divided into the control group(n=40)and observation group(n=40)according to random number table method.The control group received MWA treatment,and the observation group take compound Taxus capsule orally after MWA.The differences in short-term efficacy,adverse reactions and im-mune function indexes(CD3^(+)CD4^(+)CD8^(+)CD4^(+)/CD8^(+))were analyzed and compared between the two groups 3 months after MWA.The recurrence-freesurvival(RFS)and overall survival(OS)were compared between the two groups were followed up and compared.COX regression was used to analyze the correlation between the treat-ment and prognosis survival of the patients.Results There was no difference between the observation group and the control group in treatment efficacy and occurrence rate of ad-verse reactions 3 months after MWA(P>0.05),but CD3^(+)CD4^(+)and CD4^(+)/CD8^(+)were significantly higher than those of the control group(both P<0.05).RFS in observation group was significantly higher than that of the control group(χ^(2)=5.131,P=0.024),but there was no difference in OS between the observation group and the control group(χ^(2)=1.907,P=0.167).Compound Taxus capsule combined with MWA treatment was an inde-pendent protective factor for RFS(OR=0.309,95%CI=0.099-0.960,P=0.042),but it was not an inde-pendent influence factor for OS(P>0.05).Conclusion CompoundTaxus capsule combined with MWA can im-prove the immune function and prognosis of patients with early NSCLC to a certain extent,which has clinical significance.