脾多肽联合SOX方案新辅助治疗对进展期胃癌的影响
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摘要
目的观察进展期胃癌患者行SOX新辅助治疗方案联合脾多肽注射液治疗的近期疗效,不良反应及其对细胞免疫功能的影响来评估免疫调节剂脾多肽在胃癌新辅助治疗中的地位。方法回顾性分析2017年1月—2018年1月就诊于山西省肿瘤医院的进展期胃癌患者行SOX新辅助治疗方案联合胃癌根治术83例,就新辅助化疗期间是否应用脾多肽注射液分为两组,其中观察组34例患者,接受SOX方案同时使用脾多肽注射液,对照组49例患者只接受SOX新辅助治疗方案。观察两组患者新辅助化疗后近期疗效,不良反应以及免疫功能的状况。结果两组患者在临床缓解率上未见明显差异51.02%vs61.76%(OR=0.645,95%CI:0.265～1.570))。联合脾多肽注射液的观察组在血液学毒性反应发生率上低于对照组,其中中性粒细胞减少的比例为73.47%vs41.18%(OR=3.956 95%CI:1.558～10.074),贫血的比例为:93.88%vs61.76%(OR=9.492,95%CI:2.443～36.885)血小板减少的比例是69.39%vs35.29%(OR=4.156,95%CI:1.641～10.526)。对T细胞亚群及NK细胞的免疫功能评估中,联合脾多肽治疗的观察组在化疗前后CD3+、CD4+、CD8+、NK细胞水平与对照组相比差异有统计学意义。结论 SOX方案新辅助化疗联合脾多肽注射液治疗进展期胃癌患者,能够降低患者化疗不良反应,改善患者细胞免疫功能,提高患者手术耐受性。
Objective To evaluate the role of lienal polypeptide immunomodulator in neoadjuvant therapy of advanced gastric cancer by observing the short-term curative effect, toxicity and its effect on cellular immune function of patients with advanced gastric cancer convenient treated with SOX regimen. Methods From January2017 to August 2018, a total of 83 patients with advanced gastric cancer who were treated in Shanxi Cancer Hospital were assessed retrospectively. Among them, 34 patients in the observation group received SOX regimen and lienal polypeptide injection, while 49 patients in the control group received SOX regimen only. All patients recieved surgical treatment after neoadjuvant chemotherapy. Shortterm curative effect, toxicity and immune function were analyzed statistically. Results There was no significant differences in clinical response rate between the two groups 51.02%vs61.76%(OR=0.645(95%CI:0.265-1.570)).The incidence of toxic adverse reactions in control group was even lower. The percentage of neutrophil neutropenia was 73.47% vs41.18%(OR =3.956 95%CI:1.558-10.074), and the proportion of anemia was 93.88%vs61.76%(OR=9.492 95%CI:2.443-36.885). The proportion of thrombocytopenia was 69.39%vs35.29%(OR=4.156 95%CI:1.641-10.526) In the evaluation of T cell subsets and NK cell immune function, there was a significant difference between the observation group and the control group in the levels of CD3+, CD4+, CD8+ and NK cells before and after chemotherapy. Conclusion The lienal Polypeptide injection can reduce the toxicity, improve the cellular immune function and the patient's operating tolerance.
Objective To evaluate the role of lienal polypeptide immunomodulator in neoadjuvant therapy of advanced gastric cancer by observing the short-term curative effect, toxicity and its effect on cellular immune function of patients with advanced gastric cancer convenient treated with SOX regimen. Methods From January2017 to August 2018, a total of 83 patients with advanced gastric cancer who were treated in Shanxi Cancer Hospital were assessed retrospectively. Among them, 34 patients in the observation group received SOX regimen and lienal polypeptide injection, while 49 patients in the control group received SOX regimen only. All patients recieved surgical treatment after neoadjuvant chemotherapy. Shortterm curative effect, toxicity and immune function were analyzed statistically. Results There was no significant differences in clinical response rate between the two groups 51.02%vs61.76%(OR=0.645(95%CI:0.265-1.570)).The incidence of toxic adverse reactions in control group was even lower. The percentage of neutrophil neutropenia was 73.47% vs41.18%(OR =3.956 95%CI:1.558-10.074), and the proportion of anemia was 93.88%vs61.76%(OR=9.492 95%CI:2.443-36.885). The proportion of thrombocytopenia was 69.39%vs35.29%(OR=4.156 95%CI:1.641-10.526) In the evaluation of T cell subsets and NK cell immune function, there was a significant difference between the observation group and the control group in the levels of CD3+, CD4+, CD8+ and NK cells before and after chemotherapy. Conclusion The lienal Polypeptide injection can reduce the toxicity, improve the cellular immune function and the patient's operating tolerance.
引文
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[2] Wei Z. The influence of neoadjuvant chemotherapy on gastric cancer patients'postoperative infectious complications:What is the negative role played by the intestinal barrier dysfunction?[J]. Oncotarget, 2017,8(26):43376-43388.
[3]左婷婷.中国胃癌流行病学现状[J].中国肿瘤临床, 2017,44(1):52-58.
[4] Wilke H. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer:a phase II study with etoposide, doxorubicin, and cisplatin[J]. Journal of Clinical Oncology, 1989,7(9):1318-1326.
[5] Honma Y. Feasibility of neoadjuvant S-1 and oxaliplatin followed by surgery for resectable advanced gastric adenocarcinoma[J]. Surgery Today, 2015,46(9):1076-1082.
[6] Feng D. Surgical outcomes in patients with locally advanced gastric cancer treated with S-1 and oxaliplatin as neoadjuvant chemotherapy[J]. World Journal of Surgical Oncology, 2015, 13(1):11.
[7] Satake H. Phase I study of neoadjuvant chemotherapy with S-1 and oxaliplatin for locally advanced gastric cancer(Neo G-SOX PI)[J]. Esmo Open, 2017,2(1):e000130.
[8] Zhang J. Efficacy and safety of neoadjuvant chemotherapy with modified FOLFOX7 regimen on the treatment of advanced gastric cancer[J].中华医学杂志:英文版, 2012, 125(12):2144-2150.