放疗联合吉西他滨及顺铂放化疗对Ⅲ期非小细胞肺癌患者的疗效及QOL评分的影响
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摘要
目的研究放疗联合吉西他滨及顺铂放化疗对Ⅲ期非小细胞肺癌患者的疗效及QOL评分的影响。方法择取92例Ⅲ期非小细胞肺癌患者作为研究对象。依数字法将病患随机划分为研究组(46)和对照组(46)。研究组给予放疗联合吉西他滨及顺铂同步放化疗,对照组给予放疗联合吉西他滨及顺铂序贯放化疗。对比观察2组病患治疗后疗效、不良反应及QOL评分和免疫功能等。结果研究组治疗后完全缓解率为7. 39%(8/46)、总有效率为76. 09%(35/46),显著高于对照组的4. 35%(2/46)、41. 30%(19/46); 2组病患在治疗后均有不良发应发生,但差异不具有统计学意义(P均> 0. 05)。治疗后研究组患者总QOL为(85. 33±2. 16),显著高于对照组的(79. 48±2. 23)。治疗后研究组患者CD4+显著高于对照组,且研究组CD8+显著低于对照组,差异均有统计学意义(均P <0. 05)。结论放疗联合吉西他滨及顺铂同步放化疗对Ⅲ期NSCLC的治疗效果肯定,与序贯放化疗相比,疗效显著,患者生活质量及免疫功能更优,且不增加不良反应,值得临床借鉴。
Objective To investigate the effect of radiotherapy combined with gemcitabine and cisplatin in the treatment of patients with stage Ⅲ non-small cell lung cancer( QOL). Methods 92 patients with stage Ⅲ non-small cell lung cancer were enrolled as subjects. The patients were randomly divided into the study group( 46) and the control group( 46). The study group received radiotherapy combined with gemcitabine and cisplatin in concurrent chemoradiotherapy,and the control group received radiotherapy combined with gemcitabine and cisplatin sequential chemoradiotherapy. The therapeutic effects,adverse reactions,QOL scores and immune function of the 2 groups were compared. Results The complete remission after treatment in the study group was 17. 39%( 8/46) and the total effective rate was 76. 09%( 35/46),which was significantly higher than the control group of4. 35%( 2/46) and 41. 30%( 19/46). Adverse development should occur after treatment,but the difference was not statistically significant( all P > 0. 05). After treatment,the total QOL of the study group was( 85. 33 ± 2. 16),which was significantly higher than that of the control group( 79. 48 ± 2. 23). After treatment,the CD4 + of the study group was significantly higher than that of the control group,and the study group CD8 + was significantly lower than the control group. There had statistically significant difference( both P < 0. 05). Conclusion Radiotherapy combined with gemcitabine and cisplatin concurrent radiotherapy and chemotherapy for stage Ⅲ NSCLC is positive,compared with sequential chemoradiotherapy,the effect is significant,the patient's quality of life and immune function is better,and does not increase adverse reactions,it is worthy of clinical reference.
Objective To investigate the effect of radiotherapy combined with gemcitabine and cisplatin in the treatment of patients with stage Ⅲ non-small cell lung cancer( QOL). Methods 92 patients with stage Ⅲ non-small cell lung cancer were enrolled as subjects. The patients were randomly divided into the study group( 46) and the control group( 46). The study group received radiotherapy combined with gemcitabine and cisplatin in concurrent chemoradiotherapy,and the control group received radiotherapy combined with gemcitabine and cisplatin sequential chemoradiotherapy. The therapeutic effects,adverse reactions,QOL scores and immune function of the 2 groups were compared. Results The complete remission after treatment in the study group was 17. 39%( 8/46) and the total effective rate was 76. 09%( 35/46),which was significantly higher than the control group of4. 35%( 2/46) and 41. 30%( 19/46). Adverse development should occur after treatment,but the difference was not statistically significant( all P > 0. 05). After treatment,the total QOL of the study group was( 85. 33 ± 2. 16),which was significantly higher than that of the control group( 79. 48 ± 2. 23). After treatment,the CD4 + of the study group was significantly higher than that of the control group,and the study group CD8 + was significantly lower than the control group. There had statistically significant difference( both P < 0. 05). Conclusion Radiotherapy combined with gemcitabine and cisplatin concurrent radiotherapy and chemotherapy for stage Ⅲ NSCLC is positive,compared with sequential chemoradiotherapy,the effect is significant,the patient's quality of life and immune function is better,and does not increase adverse reactions,it is worthy of clinical reference.
引文
[1]郑伟,康静波,温居一,等.恩度联合放化疗对老年Ⅲ期非小细胞肺癌的疗效和毒副反应[J].中国医师杂志,2016,18(9):1386-1388.
[2]和劲光.替吉奥及吉西他滨分别联合奈达铂同步三维适形放射治疗Ⅲ期非小细胞肺癌的效果比较[J].中国综合临床,2016,32(8):704-708.
[3]周莉,张冠男,王琳,等.非小细胞肺癌患者外周血PD-1表达水平及淋巴细胞亚群分析[J].中国肿瘤生物治疗杂志,2016,23(3):413-415.
[4]陶秀丽,欧阳汉,吴宁,等.扩散加权成像对非小细胞肺癌放疗及同步放化疗疗效的预测价值[J].中华放射学杂志,2016,50(10):740-745.
[5]宋晓,蔡振旭,杜炜,等.血清肿瘤标志物在非小细胞肺癌放化疗后疗效评估和预后判断中的价值[J].中国医药,2016,11(5):664-666.
[6]周熙平.含顺铂的三组联合化疗方案治疗晚期非小细胞肺癌的随机对照临床研究[J].中国急救医学,2015,35(z2):134-135.
[7]沙晓锋,张姣,韦淑贞,等.放疗联合吉西他滨加顺铂同步与序贯放化疗对Ⅲ期不能手术非小细胞肺癌疗效对比研究[J].中国医学前沿杂志(电子版),2016,8(4):49-52.
[8]孟玲楠,石砂硼,林珊,等.不同放化疗模式治疗中晚期非小细胞肺癌的疗效分析[J].现代生物医学进展,2016,16(29):5658-5662.
[9]陈宝玉,房振羽,刘德干,等.GP方案序贯三维适形放疗治疗老年局部晚期非小细胞肺癌疗效观察[J].现代肿瘤医学,2013,21(8):1781-1783.
[10]高春玲,王笑良,吴晓安,等.吉西他滨/长春瑞滨对Ⅲ~Ⅳ期非小细胞肺癌的放射增敏作用[J].实用癌症杂志,2012,27(1):48-51.
[11]郑伟,聂青,康静波,等.老年Ⅲ期非小细胞肺癌同步放化疗的临床对照研究[J].中华肿瘤防治杂志,2012,19(4):292-296.
[12]石文波,曹华,冉瑞智,等.生物免疫疗法联合放化疗应用于局限期非小细胞肺癌治疗效果及对免疫功能的影响[J].临床肺科杂志,2017,22(1):18-21.
[13]费新雄,蒋忠君,程国平,等.90例晚期非小细胞肺癌调强放疗同步化疗治疗疗效[J].肿瘤学杂志,2016,22(9):765-767.
[14]杜军华,乔洪源,尹宜发,等.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137-140.
[15]吴晶,刘艳屏,龙志雄,等.多西他赛联合洛铂方案与多西他赛联合顺铂方案同步放化疗治疗晚期非小细胞肺癌的随机对照研究[J].转化医学杂志,2016,5(2):70-73.
[2]和劲光.替吉奥及吉西他滨分别联合奈达铂同步三维适形放射治疗Ⅲ期非小细胞肺癌的效果比较[J].中国综合临床,2016,32(8):704-708.
[3]周莉,张冠男,王琳,等.非小细胞肺癌患者外周血PD-1表达水平及淋巴细胞亚群分析[J].中国肿瘤生物治疗杂志,2016,23(3):413-415.
[4]陶秀丽,欧阳汉,吴宁,等.扩散加权成像对非小细胞肺癌放疗及同步放化疗疗效的预测价值[J].中华放射学杂志,2016,50(10):740-745.
[5]宋晓,蔡振旭,杜炜,等.血清肿瘤标志物在非小细胞肺癌放化疗后疗效评估和预后判断中的价值[J].中国医药,2016,11(5):664-666.
[6]周熙平.含顺铂的三组联合化疗方案治疗晚期非小细胞肺癌的随机对照临床研究[J].中国急救医学,2015,35(z2):134-135.
[7]沙晓锋,张姣,韦淑贞,等.放疗联合吉西他滨加顺铂同步与序贯放化疗对Ⅲ期不能手术非小细胞肺癌疗效对比研究[J].中国医学前沿杂志(电子版),2016,8(4):49-52.
[8]孟玲楠,石砂硼,林珊,等.不同放化疗模式治疗中晚期非小细胞肺癌的疗效分析[J].现代生物医学进展,2016,16(29):5658-5662.
[9]陈宝玉,房振羽,刘德干,等.GP方案序贯三维适形放疗治疗老年局部晚期非小细胞肺癌疗效观察[J].现代肿瘤医学,2013,21(8):1781-1783.
[10]高春玲,王笑良,吴晓安,等.吉西他滨/长春瑞滨对Ⅲ~Ⅳ期非小细胞肺癌的放射增敏作用[J].实用癌症杂志,2012,27(1):48-51.
[11]郑伟,聂青,康静波,等.老年Ⅲ期非小细胞肺癌同步放化疗的临床对照研究[J].中华肿瘤防治杂志,2012,19(4):292-296.
[12]石文波,曹华,冉瑞智,等.生物免疫疗法联合放化疗应用于局限期非小细胞肺癌治疗效果及对免疫功能的影响[J].临床肺科杂志,2017,22(1):18-21.
[13]费新雄,蒋忠君,程国平,等.90例晚期非小细胞肺癌调强放疗同步化疗治疗疗效[J].肿瘤学杂志,2016,22(9):765-767.
[14]杜军华,乔洪源,尹宜发,等.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137-140.
[15]吴晶,刘艳屏,龙志雄,等.多西他赛联合洛铂方案与多西他赛联合顺铂方案同步放化疗治疗晚期非小细胞肺癌的随机对照研究[J].转化医学杂志,2016,5(2):70-73.