CAJ | 학술논문

目的：探讨复方阿胶浆对吉西他滨联合顺铂（ GP ）化疗方案导致骨髓抑制的疗效及安全性。方法选取2011年1月至2012年6月行GP方案化疗的119例恶性肿瘤患者，分为对照组（ n＝55）和治疗组（ n＝64），两组均给予GP方案（吉西他滨1g/m2，d1、d8；顺铂20mg/m2，d1～d8；21天为1周期），治疗组于化疗前1～2天开始口服复方阿胶浆，20ml/次，每日3次，直至化疗结束后1周。比较两组化疗期间使用重组人白细胞介素-11（ rhIL-11）和重组人粒细胞集落刺激因子（ rhG-CSF）的剂量，以及第1、2个周期化疗前的血小板、白细胞计数及化疗后的血小板、白细胞计数最低值和因骨髓抑制导致的化疗推迟率，同时化疗2个周期后采用实体瘤疗效评价标准（ RECIST）1?1版评价近期疗效。结果治疗组的rhIL-11和rhG-CSF用量均低于对照组（ P＜0?05）；两组第1、2个周期化疗前的血小板、白细胞计数的差异无统计学意义（ P＞0?05）；治疗组第1、2个周期化疗后的血小板计数最低值高于对照组（ P＜0?05），但两组第1、2个周期化疗后的白细胞计数最低值的差异无统计学意义（ P＞0?05）。治疗组按时完成107个化疗周期，推迟21个；而对照组按时完成75个化疗周期，推迟35个；治疗组的化疗推迟率低于对照组（16?2％ vs．32?1％， P＜0?05）。对照组的有效率和临床控制率分别为49?09％和85?45％，与治疗组的43?75％和79?69％比较，差异无统计学意义（ P＞0?05）。治疗组服用复方阿胶浆期间未见任何明确相关的不适感及副作用。结论复方阿胶浆可改善GP方案化疗导致的骨髓抑制，有效提高外周血中血小板水平，对化疗的近期疗效无负面影响，但其长期效果仍需进一步观察。
목적：탐토복방아효장대길서타빈연합순박（ GP ）화료방안도치골수억제적료효급안전성。방법선취2011년1월지2012년6월행GP방안화료적119례악성종류환자，분위대조조（ n＝55）화치료조（ n＝64），량조균급여GP방안（길서타빈1g/m2，d1、d8；순박20mg/m2，d1～d8；21천위1주기），치료조우화료전1～2천개시구복복방아효장，20ml/차，매일3차，직지화료결속후1주。비교량조화료기간사용중조인백세포개소-11（ rhIL-11）화중조인립세포집락자격인자（ rhG-CSF）적제량，이급제1、2개주기화료전적혈소판、백세포계수급화료후적혈소판、백세포계수최저치화인골수억제도치적화료추지솔，동시화료2개주기후채용실체류료효평개표준（ RECIST）1?1판평개근기료효。결과치료조적rhIL-11화rhG-CSF용량균저우대조조（ P＜0?05）；량조제1、2개주기화료전적혈소판、백세포계수적차이무통계학의의（ P＞0?05）；치료조제1、2개주기화료후적혈소판계수최저치고우대조조（ P＜0?05），단량조제1、2개주기화료후적백세포계수최저치적차이무통계학의의（ P＞0?05）。치료조안시완성107개화료주기，추지21개；이대조조안시완성75개화료주기，추지35개；치료조적화료추지솔저우대조조（16?2％ vs．32?1％， P＜0?05）。대조조적유효솔화림상공제솔분별위49?09％화85?45％，여치료조적43?75％화79?69％비교，차이무통계학의의（ P＞0?05）。치료조복용복방아효장기간미견임하명학상관적불괄감급부작용。결론복방아효장가개선GP방안화료도치적골수억제，유효제고외주혈중혈소판수평，대화료적근기료효무부면영향，단기장기효과잉수진일보관찰。
Objective To investigate the effect of donkey-hide gelatin mixture on myelosuppression induced by gemcitabine and cisplatin ( GP ) chemotherapy. Methods According to the treatment, 119 patients with malignant tumor from 2011 January to 2012 June were assigned into treatment group( n=64) and control group( n=55) . Both groups received GP regime ( gemcitabine, 1g/m2 , d1 , d8;cisplatin, 20mg/m2 , d1-d8;21 days was a cycle) for chemotherapy. Only the treatment group received donkey-hide gelat-in mixture ( 20ml per time, tid) from 1-2 days before chemotherapy to one week after the end of chemotherapy. The usage of chemo-therapy of interleukin-11 ( rhIL-11 ) and recombinant human granulocyte colony stimulating factor ( rhG-CSF ) during chemotherapy were compared between two groups. The white cell counts and platelet counts before the 1st and 2nd cycle of chemotherapy, minimum values of white cell count and platelet count after 1st and 2nd cycle of chemotherapy and postponed rates caused by bone marrow suppres-sion were recorded between groups. The Response Evaluation Criteria in Solid Tumors ( RECIST) criteria ( version 1?1) was employed to evaluate the short-term effect after chemotherapy for 2 cycles. Results The usage of both rhIL-11 and rhG-CSF in treatment group were lower than those in control group ( P<0?05) . No statistically significant difference was observed between both groups on platelet counts and blood cell counts before the 1st and 2nd cycle of chemotherapy ( P>0?05) . The minimum values of platelet count were higher in treatment group versus control group after the 1st and 2nd cycle of chemotherapy ( P<0?05) , but the minimum values of blood cell counts were similar between groups ( P>0?05) . The treatment group completed 107 cycles of chemotherapy on schedule, while the con-trol group completed 75 cycles of chemotherapy on schedule. The postponed rates of treatment group was lower than that of control group ( 16?2% vs. 32?1%, P<0?05) . The response rates and disease control rates were 49?09% and 85?45% in control group and 43?75%and 79?69% in treatment group without significant differences ( P>0?05) . During the process of donkey-hide gelatin mixture, no clear discomfort and side effects were observed. Conclusion Donkey-hide gelatin mixture can relieve the myelosuppression caused by GP regimen chemotherapy and increases blood platelets count after chemotherapy. The long-term effects on chemotherapy efficacy needed to be observed, and the mechanism for the efficacy should be investigated furthermore.