参麦注射液联合TP治疗卵巢癌的临床疗效观察
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摘要
目的
探讨参麦注射液联合紫杉醇、顺铂(TP方案)化疗与单纯TP方案化疗对晚期卵巢癌的疗效、不良反应及免疫功能的影响。
方法
将60例晚期卵巢癌患者分为参麦组和对照组,两组均采用TP方案化疗(紫杉醇135mg/m2,顺铂75mg/m2),每3-4周为一个疗程,共六个疗程。化疗前12h及6h各口服地塞米松20mg；化疗前30min给予苯海拉明50mg及雷尼替丁50mg静注。对照组仅接受TP化疗,参麦组在化疗前3天开始使用参麦注射液50ml加入5%葡萄糖250ml中,静脉滴注,1次/日,连续10天；第4天开始实施相应的化疗方案。观察化疗前后T淋巴细胞亚群的变化,临床有效率及毒副作用。
结果
1.参麦组治疗前后CD3、CD4、CD8无明显改变(P>0.05)；对照组治疗后CD3、CD4、CD8较治疗前明显下降,且均低于参麦组治疗后(P<0.05)。
2.参麦组有效率70.0%与对照组有效率63.3%比较,差异无统计学意义(P>0.05)。
3. Kamofsky评分,参麦组治疗前78.6±4.5与治疗后70.7±7.1比较无差异(P>0.05)；对照组治疗后61.2±3.7明显低于治疗前的77.6±5.0(P<0.05),对照组治疗后与参麦组治疗后比较有统计学差异(P<0.05)。
4.两组患者比较,白细胞减少、血小板减少、恶心、呕吐毒副作用发生率参麦组明显低于对照组(P<0.05)。对肝、肾功能两组均无明显影响。
结论
参麦注射液联合TP方案治疗晚期卵巢癌,降低了TP化疗方案对免疫功能的影响和对胃肠道的不良反应,具有较高的临床应用价值。
Objective
To research the curative effect and side effect of Shenmai injection plus TP chems for treating late-stage ovarian cancer.
Methods
The patients of 60 ovarian cancer divided equally into Shenmai group and control group. All patients were given TP chems keep on six times of therapy. Before the chems, the patients were taken dexamethasone 20 mg orally, intravenous injection of benzhydramine 50 mg and ranitidine 50 mg. Before the three days of chems, the Shenmai group was given Shenmai injection 50ml, continued 10 days, and gave chems at the fourth day. Before and after treatment, T-cell subpopulation, clinical effects and side effects were observed.
Results
1. Before and after treatment, The CD3, CD4 and CD8 of Shenmai group had no significant change (P>0.05). The control group had significantly decrease (P<0.05).
2. The effective rate in Shenmai group was 70.0%, compared with the control group 63.3% had no statistical significance (P>0.05).
3. The score of Karnofsky, The before and after of treatment, the Shenmai group had no significant change (P>0.05). The pretherapy of control group 77.6±5.0 had descent compared with post-treatment 61.2±3.7 (P<0.05).
4. The incidence rate of side effects had significant statistical significance (P<0.05) between two groups.
Conclusion
Shenmai injection combined with TP is effective in treatment of patients with late-stage ovarian cancer, and deserve to generalization of clinical application.
探讨参麦注射液联合紫杉醇、顺铂(TP方案)化疗与单纯TP方案化疗对晚期卵巢癌的疗效、不良反应及免疫功能的影响。
方法
将60例晚期卵巢癌患者分为参麦组和对照组,两组均采用TP方案化疗(紫杉醇135mg/m2,顺铂75mg/m2),每3-4周为一个疗程,共六个疗程。化疗前12h及6h各口服地塞米松20mg；化疗前30min给予苯海拉明50mg及雷尼替丁50mg静注。对照组仅接受TP化疗,参麦组在化疗前3天开始使用参麦注射液50ml加入5%葡萄糖250ml中,静脉滴注,1次/日,连续10天；第4天开始实施相应的化疗方案。观察化疗前后T淋巴细胞亚群的变化,临床有效率及毒副作用。
结果
1.参麦组治疗前后CD3、CD4、CD8无明显改变(P>0.05)；对照组治疗后CD3、CD4、CD8较治疗前明显下降,且均低于参麦组治疗后(P<0.05)。
2.参麦组有效率70.0%与对照组有效率63.3%比较,差异无统计学意义(P>0.05)。
3. Kamofsky评分,参麦组治疗前78.6±4.5与治疗后70.7±7.1比较无差异(P>0.05)；对照组治疗后61.2±3.7明显低于治疗前的77.6±5.0(P<0.05),对照组治疗后与参麦组治疗后比较有统计学差异(P<0.05)。
4.两组患者比较,白细胞减少、血小板减少、恶心、呕吐毒副作用发生率参麦组明显低于对照组(P<0.05)。对肝、肾功能两组均无明显影响。
结论
参麦注射液联合TP方案治疗晚期卵巢癌,降低了TP化疗方案对免疫功能的影响和对胃肠道的不良反应,具有较高的临床应用价值。
Objective
To research the curative effect and side effect of Shenmai injection plus TP chems for treating late-stage ovarian cancer.
Methods
The patients of 60 ovarian cancer divided equally into Shenmai group and control group. All patients were given TP chems keep on six times of therapy. Before the chems, the patients were taken dexamethasone 20 mg orally, intravenous injection of benzhydramine 50 mg and ranitidine 50 mg. Before the three days of chems, the Shenmai group was given Shenmai injection 50ml, continued 10 days, and gave chems at the fourth day. Before and after treatment, T-cell subpopulation, clinical effects and side effects were observed.
Results
1. Before and after treatment, The CD3, CD4 and CD8 of Shenmai group had no significant change (P>0.05). The control group had significantly decrease (P<0.05).
2. The effective rate in Shenmai group was 70.0%, compared with the control group 63.3% had no statistical significance (P>0.05).
3. The score of Karnofsky, The before and after of treatment, the Shenmai group had no significant change (P>0.05). The pretherapy of control group 77.6±5.0 had descent compared with post-treatment 61.2±3.7 (P<0.05).
4. The incidence rate of side effects had significant statistical significance (P<0.05) between two groups.
Conclusion
Shenmai injection combined with TP is effective in treatment of patients with late-stage ovarian cancer, and deserve to generalization of clinical application.
引文
[1]彭澎.卵巢癌肿瘤疫苗研究进展[J].中华妇产科杂志,2004,7：500-502
[2]周际吕.实用肿瘤内科学2版,北京：人民卫生出版社,2003：45-46
[3]包碧惠,柏朝益,唐小丽等.泰素联合顺铂治疗老年期卵巢癌16例.临床军医杂志,2001,29(4)：54-55
[4]周宏灏主编.分子药理学,哈尔滨：黑龙江科学技术出版社,1999：144-160
[5]刘英光,李群,张彦.紫杉醇与顺铂联合化疗治疗晚期卵巢癌临床研究.青岛医药卫生,2006,38(6)：411-412
[6]Amit Y, Cashore W, Schiff D. Studies of bilirubin toxicity at the synaptosome and cellular levels. Semin Perinatol 1992,16(3):186-190
[7]Rao S, Orr GA, Chaudhary AG, et al. Characterization of the taxol binding site on the microtubule 2-(m-Azidobenzoy) taxol photolables a peptide (amino acids 217-213) of beta-tubulin. J Biol Chem,1995,270(35):20235-20238
[8]Moritz M, Braundfeld MB, Sedat JW, et al. Microtubule nucleation by gamma-tubulin-containing rings in the centrosome. Nature,1995,378(7):638-640
[9]Ranganathan S, Benetatos CA, Colarusso PJ. Altered beta-tubulin isotype expression in paclitaxel-resistant human prostate carcinoma cell. Br J Cancer,1998,77(4):562-566
[10]Chang HC, Weng CF. Cyclooxygenase-2 level and culture conditions influence NS398-induced apoptosis and caspase activation in lung cancer cells. Oncol Rep 2001,8(6): 1321-1325
[11]亓放,张宝泉,徐炎,等.顺铂诱导的喉癌细胞凋亡及其对细胞周期的影响.中华医学杂志,1999,79(4)：298-301
[12]Eder JP Jr, Chan VT, Ng SW, et al. DNA topoisomerase II alpha expression is associated with alkylating agent resistance. Cancer Res,1995,55(24):6109-6116
[13]赵卫红,寿好长.G2-M期阻滞与肿瘤.国外医学肿瘤学分册,1999,26(2)：76-78
[14]曾益新,主编.肿瘤学.第二版.北京：人民卫生出版社,2003.152
[15]Wang W, Heideomn L, Chung CS, et al. Cell-cycle arrest at G2/M and growth inhibition by apigenin in human colon carcinoma cell lines.Mol Carcinog,2000,28(2):102-110
[16]Ho YS, Duh JS, Jeng JH, et al. Griesofulvin potentiates antitumorigenesis effect of nocodazole through induction of apoptosis and G2/M cell cycle arrest in human colorectal cancer cells. Int J Cancer,2001,91(3):393-401
[17]Cohen C, Lohmann CM, Cotsonis G, et al. Survivin expression in ovarian carcinoma: correlation with apoptotic markers and prognosis. Mod Pathol,2003,16(6):574-583
[18]Lotze MF, Finn OJ. Recent advance in cellular immuneology:implications for immunity to cancer. Imunol Today,1990,11(6):190
[19]陈曦,黄晓娟,宋健斌.参麦注射液配合化疗治疗恶性肿瘤疗效观察.航空航天医药,2009,20(2)：69-70
[1]Chen T, Wang Z, WangR, et al. Polyethylenimine-DNA solid particles for gene delivery. J Drug Target,2007,15(10):714-72.
[2]Ghataorhe P, Kurian AW, PickartA, et a.l A carrier of both MEN1 and BRCA2 mutations: case reportand review of the literature [J]. CancerGenetCytogenet,2007,179(2):89-92.
[3]Schmutzler RK. Moleculargenetics and clinics ofhereditary breast cancer [J]. Verh Dtsch GesPatho,l 2005,89:25-34.
[4]ECCLES D M, BRETT L, LESSELLS A, et al. Overexpression of the P53 protein and allele loss at 17p13 in ovarian carcinoma [J]. Cancer,1992,65(1):40
[5]Marchini S, MarabeseM, Marrazzo E, et a.l DeltaNp63 expression is associated with poor survival in ovarian cancer [J]. Ann Onco,l 2007,12(5):367-369.
[6]Gatcliffe TA, Monk BJ, PlanutisK, eta.l Wnt signaling in ovarian tumorigenesis [J]. Int JGynecolCancer,2007,6(3):265-269.
[7]WuHJ, WuHT, WengDH, et a.l Reversal of drug resistance in human ovarian cancer cells by wild-type PTEN gene and its mechanisms [J]. Zhonghua Fu Chan Ke Za Zh,i 2007, 42(9):612-616.
[8]Takai N, Narahara H. Human endometrial and ovarian cancer cells:histone deacetylase inhibitors exhibitantiproliferative activity, potently induce cell cycle arrest, and stimulate apoptosis. CurrMed Chem,2007,14(24):2548-2553
[9]Park HY. Inhibition of the proliferative effect transforming growth factor-alpha by c-myc antisense DAN in human ovarian cancer cells. Biochem Mol Boil Int,1997,43 (5): 1015-1022
[10]Janicek MF, Sevin BU, Nguyen HN, et al. Combination anti-gene therapy targeting c-myc and P53 in ovarian cancer cell lines. Genecol Oncol,1995,59:87-92
[11]Mayfield C, Squibb M, Miller D. Inhibition of nuclear protein binding to the human Ki-ras promoter by triplex-forming oligonucleotides. Biochemistry,1994,33(11):3358-3363
[12]Deshane J, Cabrera G, Grim JE, et al. Targeted eradication of overian cancer mediated by intracellular expression of anti-erbB-2 single-chain antibody. Gynecol Oncol,1995,59 (1): 8-14
[13]Kashani-Sabet M, Funato T, Florenes VA, et al. Suppression of the neoplastic phenotype in vivo by an anti-ras ribzyome. Cancer Res,1994,54 (4):900-902
[14]Arap W, Nishikawa R, Furnari FB, et al. Replacement of the P16/CDKN2 gene suppresses human glioma cell growth. Cancer Res,1995,55(6):1351-1354
[15]Choudhurg A, Charo J, Parapuram SK, et al. Small interfering RNA (siRNA) inhibits the expression of the Her-2/neu gene, upregulates HLA class I and induces apoptosis of Her-2/neu positive tumor cell lines. Int J Cancer,2004,108(1):71-77
[16]Abedini MR, Qiu Q, Yan X, et al. Possible role of FLICE-like inhibitory protein (FLIP) in chemoresistant ovarian cancer cells in vitro. Oncogene,2004,23(42):6997-7004
[17]Landen CN Jr, Chavez-Reyes A, Bucana C, et al. Therapeutic EphA2 gene targeting in vivo using neutral liposomal small interfering RNA delivery. Cancer Res,2005,65(15): 6910-6918
[18]Tanaka M, Inase N, Miyake S, et al. Neuron specific enolase promoter for suicide gene therapy in small lung carcinoma. Anticancer Res,2001,21(1A):291-294
[19]Ziller C, Lincet H, Muller CD, et al. The cyclin-dependent kinase inhibitor p21 (cipl/waf1) enhances the cytotoxicity of ganciclovir in HSV-tk transfected ovarian carcinoma cells. Cancer Lett,2004,212 (1):43-52
[20]Fei R, Shaoyang L. Combination antigene therapy targeting c-myc and c-erbB(2) in the ovarian cancer COC(1) cell line. Gynecol Oncol,2002,85(1):40-44
[21]Wolf JK, Bodurka DC, Gano JB. et al. A phase I study of Adp53 (INGN 201; ADVEXIN) for patients with platinum-and paclitaxel-esistant epithelial ovarian cancer. Gynecol Oncol, 2004,94(2):442-448
[22]Green H, Soderkvist P, Rosenberg P, et al. Mdr-1single nucleotide Polymorphisms in ovarian cancer tissue:G2677T/A correlates with response topaclitaxel chemotherapy. Clin Cancer Res,2006,12(3):854-859.
[23]阮菲.卵巢癌的基因治疗.国外医学·妇产科学分册,2001,28(4)：217
[24]Yamaguchi Y, Takashima I, Hihara J, et al. Co-transduction of herpes simplex virus thymidine kinase gene and human interleukin-2 gene into mouse ovarian cancer cell line, OVHM. Int J Mol Med,2000,6(2):185
[25]程蓓.卵巢癌细胞因子基因治疗.浙江医学,2000,22(11)：699
[26]Burke F, East N, Upton C, et al. Interferon gamma induces cell cycle arrest and apoptosis in a mode if ovarian cancer:enhancement of effect by batimastat. Eur J Cancer,1997, 33(7):1114-1121
[27]Bauerschmitz GJ, Lam JT, Kanerva A, et al. Treatment of ovarian cancer with a tropism modified oncolytic adenovirus. Cancer Res,2002,62:1266-1270
[28]Stallwood Y, Fisher KD, Gallimore PH, et al. Neutralisation of adenovirus infectivity by ascitic fluid from ovarian cancer patients. Gene Ther 2000,7(8):637-643
[29]Zinn K R, Chaudhuri TR, Buchsbaum DJ, et al. Detection and measurement of in vitro gene transfer by gamma camera imaging. Gene Ther,2001,8(4):291-299
[2]周际吕.实用肿瘤内科学2版,北京：人民卫生出版社,2003：45-46
[3]包碧惠,柏朝益,唐小丽等.泰素联合顺铂治疗老年期卵巢癌16例.临床军医杂志,2001,29(4)：54-55
[4]周宏灏主编.分子药理学,哈尔滨：黑龙江科学技术出版社,1999：144-160
[5]刘英光,李群,张彦.紫杉醇与顺铂联合化疗治疗晚期卵巢癌临床研究.青岛医药卫生,2006,38(6)：411-412
[6]Amit Y, Cashore W, Schiff D. Studies of bilirubin toxicity at the synaptosome and cellular levels. Semin Perinatol 1992,16(3):186-190
[7]Rao S, Orr GA, Chaudhary AG, et al. Characterization of the taxol binding site on the microtubule 2-(m-Azidobenzoy) taxol photolables a peptide (amino acids 217-213) of beta-tubulin. J Biol Chem,1995,270(35):20235-20238
[8]Moritz M, Braundfeld MB, Sedat JW, et al. Microtubule nucleation by gamma-tubulin-containing rings in the centrosome. Nature,1995,378(7):638-640
[9]Ranganathan S, Benetatos CA, Colarusso PJ. Altered beta-tubulin isotype expression in paclitaxel-resistant human prostate carcinoma cell. Br J Cancer,1998,77(4):562-566
[10]Chang HC, Weng CF. Cyclooxygenase-2 level and culture conditions influence NS398-induced apoptosis and caspase activation in lung cancer cells. Oncol Rep 2001,8(6): 1321-1325
[11]亓放,张宝泉,徐炎,等.顺铂诱导的喉癌细胞凋亡及其对细胞周期的影响.中华医学杂志,1999,79(4)：298-301
[12]Eder JP Jr, Chan VT, Ng SW, et al. DNA topoisomerase II alpha expression is associated with alkylating agent resistance. Cancer Res,1995,55(24):6109-6116
[13]赵卫红,寿好长.G2-M期阻滞与肿瘤.国外医学肿瘤学分册,1999,26(2)：76-78
[14]曾益新,主编.肿瘤学.第二版.北京：人民卫生出版社,2003.152
[15]Wang W, Heideomn L, Chung CS, et al. Cell-cycle arrest at G2/M and growth inhibition by apigenin in human colon carcinoma cell lines.Mol Carcinog,2000,28(2):102-110
[16]Ho YS, Duh JS, Jeng JH, et al. Griesofulvin potentiates antitumorigenesis effect of nocodazole through induction of apoptosis and G2/M cell cycle arrest in human colorectal cancer cells. Int J Cancer,2001,91(3):393-401
[17]Cohen C, Lohmann CM, Cotsonis G, et al. Survivin expression in ovarian carcinoma: correlation with apoptotic markers and prognosis. Mod Pathol,2003,16(6):574-583
[18]Lotze MF, Finn OJ. Recent advance in cellular immuneology:implications for immunity to cancer. Imunol Today,1990,11(6):190
[19]陈曦,黄晓娟,宋健斌.参麦注射液配合化疗治疗恶性肿瘤疗效观察.航空航天医药,2009,20(2)：69-70
[1]Chen T, Wang Z, WangR, et al. Polyethylenimine-DNA solid particles for gene delivery. J Drug Target,2007,15(10):714-72.
[2]Ghataorhe P, Kurian AW, PickartA, et a.l A carrier of both MEN1 and BRCA2 mutations: case reportand review of the literature [J]. CancerGenetCytogenet,2007,179(2):89-92.
[3]Schmutzler RK. Moleculargenetics and clinics ofhereditary breast cancer [J]. Verh Dtsch GesPatho,l 2005,89:25-34.
[4]ECCLES D M, BRETT L, LESSELLS A, et al. Overexpression of the P53 protein and allele loss at 17p13 in ovarian carcinoma [J]. Cancer,1992,65(1):40
[5]Marchini S, MarabeseM, Marrazzo E, et a.l DeltaNp63 expression is associated with poor survival in ovarian cancer [J]. Ann Onco,l 2007,12(5):367-369.
[6]Gatcliffe TA, Monk BJ, PlanutisK, eta.l Wnt signaling in ovarian tumorigenesis [J]. Int JGynecolCancer,2007,6(3):265-269.
[7]WuHJ, WuHT, WengDH, et a.l Reversal of drug resistance in human ovarian cancer cells by wild-type PTEN gene and its mechanisms [J]. Zhonghua Fu Chan Ke Za Zh,i 2007, 42(9):612-616.
[8]Takai N, Narahara H. Human endometrial and ovarian cancer cells:histone deacetylase inhibitors exhibitantiproliferative activity, potently induce cell cycle arrest, and stimulate apoptosis. CurrMed Chem,2007,14(24):2548-2553
[9]Park HY. Inhibition of the proliferative effect transforming growth factor-alpha by c-myc antisense DAN in human ovarian cancer cells. Biochem Mol Boil Int,1997,43 (5): 1015-1022
[10]Janicek MF, Sevin BU, Nguyen HN, et al. Combination anti-gene therapy targeting c-myc and P53 in ovarian cancer cell lines. Genecol Oncol,1995,59:87-92
[11]Mayfield C, Squibb M, Miller D. Inhibition of nuclear protein binding to the human Ki-ras promoter by triplex-forming oligonucleotides. Biochemistry,1994,33(11):3358-3363
[12]Deshane J, Cabrera G, Grim JE, et al. Targeted eradication of overian cancer mediated by intracellular expression of anti-erbB-2 single-chain antibody. Gynecol Oncol,1995,59 (1): 8-14
[13]Kashani-Sabet M, Funato T, Florenes VA, et al. Suppression of the neoplastic phenotype in vivo by an anti-ras ribzyome. Cancer Res,1994,54 (4):900-902
[14]Arap W, Nishikawa R, Furnari FB, et al. Replacement of the P16/CDKN2 gene suppresses human glioma cell growth. Cancer Res,1995,55(6):1351-1354
[15]Choudhurg A, Charo J, Parapuram SK, et al. Small interfering RNA (siRNA) inhibits the expression of the Her-2/neu gene, upregulates HLA class I and induces apoptosis of Her-2/neu positive tumor cell lines. Int J Cancer,2004,108(1):71-77
[16]Abedini MR, Qiu Q, Yan X, et al. Possible role of FLICE-like inhibitory protein (FLIP) in chemoresistant ovarian cancer cells in vitro. Oncogene,2004,23(42):6997-7004
[17]Landen CN Jr, Chavez-Reyes A, Bucana C, et al. Therapeutic EphA2 gene targeting in vivo using neutral liposomal small interfering RNA delivery. Cancer Res,2005,65(15): 6910-6918
[18]Tanaka M, Inase N, Miyake S, et al. Neuron specific enolase promoter for suicide gene therapy in small lung carcinoma. Anticancer Res,2001,21(1A):291-294
[19]Ziller C, Lincet H, Muller CD, et al. The cyclin-dependent kinase inhibitor p21 (cipl/waf1) enhances the cytotoxicity of ganciclovir in HSV-tk transfected ovarian carcinoma cells. Cancer Lett,2004,212 (1):43-52
[20]Fei R, Shaoyang L. Combination antigene therapy targeting c-myc and c-erbB(2) in the ovarian cancer COC(1) cell line. Gynecol Oncol,2002,85(1):40-44
[21]Wolf JK, Bodurka DC, Gano JB. et al. A phase I study of Adp53 (INGN 201; ADVEXIN) for patients with platinum-and paclitaxel-esistant epithelial ovarian cancer. Gynecol Oncol, 2004,94(2):442-448
[22]Green H, Soderkvist P, Rosenberg P, et al. Mdr-1single nucleotide Polymorphisms in ovarian cancer tissue:G2677T/A correlates with response topaclitaxel chemotherapy. Clin Cancer Res,2006,12(3):854-859.
[23]阮菲.卵巢癌的基因治疗.国外医学·妇产科学分册,2001,28(4)：217
[24]Yamaguchi Y, Takashima I, Hihara J, et al. Co-transduction of herpes simplex virus thymidine kinase gene and human interleukin-2 gene into mouse ovarian cancer cell line, OVHM. Int J Mol Med,2000,6(2):185
[25]程蓓.卵巢癌细胞因子基因治疗.浙江医学,2000,22(11)：699
[26]Burke F, East N, Upton C, et al. Interferon gamma induces cell cycle arrest and apoptosis in a mode if ovarian cancer:enhancement of effect by batimastat. Eur J Cancer,1997, 33(7):1114-1121
[27]Bauerschmitz GJ, Lam JT, Kanerva A, et al. Treatment of ovarian cancer with a tropism modified oncolytic adenovirus. Cancer Res,2002,62:1266-1270
[28]Stallwood Y, Fisher KD, Gallimore PH, et al. Neutralisation of adenovirus infectivity by ascitic fluid from ovarian cancer patients. Gene Ther 2000,7(8):637-643
[29]Zinn K R, Chaudhuri TR, Buchsbaum DJ, et al. Detection and measurement of in vitro gene transfer by gamma camera imaging. Gene Ther,2001,8(4):291-299