CAJ | 학술논문

目的：探讨紫杉醇联合顺铂不同给药途径化疗治疗晚期卵巢癌的临床效果以及对患者免疫调节的作用。方法选取94例晚期卵巢癌患者，随机分为观察组和对照组2组。观察组47例采用紫杉醇联合顺铂腹腔灌注化疗，对照组47例采用紫杉醇联合顺铂静脉滴注化疗，2组所用药用剂量相同，3周为1疗程。完成2个疗程后进行疗效评价，测定外周血CD 4+CD 25+细胞阳性率变化和CD 4+/CD 8+比值变化，记录患者无进展生存期和3年生存率，观察药物毒副反应。结果2组患者均可评价客观疗效。观察组RR和DC分别为78.7%、91.5%，显著高于对照组。至随访期结束，2组无进展生存期相比差异具有统计学意义。2组患者免疫细胞CD 4+CD 25+阳性率在接受2疗程化疗后与化疗前相比比率下降，与化疗前相比差异均具有统计学意义；2组免疫细胞CD 4+/CD 8+比值在化疗2疗程后均升高，与化疗前相比差异均具有统计学意义。2组不良反应主要为骨髓抑制和神经毒性，但均未出现因不良反应而终止耐受者。结论采用紫杉醇联合顺铂腹腔灌注化疗治疗晚期卵巢癌，疗效好，毒副作用小，安全性高，值得临床应用。
목적：탐토자삼순연합순박불동급약도경화료치료만기란소암적림상효과이급대환자면역조절적작용。방법선취94례만기란소암환자，수궤분위관찰조화대조조2조。관찰조47례채용자삼순연합순박복강관주화료，대조조47례채용자삼순연합순박정맥적주화료，2조소용약용제량상동，3주위1료정。완성2개료정후진행료효평개，측정외주혈CD 4+CD 25+세포양성솔변화화CD 4+/CD 8+비치변화，기록환자무진전생존기화3년생존솔，관찰약물독부반응。결과2조환자균가평개객관료효。관찰조RR화DC분별위78.7%、91.5%，현저고우대조조。지수방기결속，2조무진전생존기상비차이구유통계학의의。2조환자면역세포CD 4+CD 25+양성솔재접수2료정화료후여화료전상비비솔하강，여화료전상비차이균구유통계학의의；2조면역세포CD 4+/CD 8+비치재화료2료정후균승고，여화료전상비차이균구유통계학의의。2조불량반응주요위골수억제화신경독성，단균미출현인불량반응이종지내수자。결론채용자삼순연합순박복강관주화료치료만기란소암，료효호，독부작용소，안전성고，치득림상응용。
Objective To investigatethe the clinical efifcacy and immunomodulatory effect of paclitaxel and cisplatin in treatment of advanced ovarian carcinoma by different administration ways. Methods 94 patients with advanced ovarian carcinoma were randomly divided into observation group and control group. Patients in observation group (47 cases) were treats with paclitaxel plus cisplation by intraperitoneal infusion chemotherapy, the other patients (47 cases) who are in control group were treats with paclitaxel plus cisplation by intravenous chemotherapy. Two groups used the same medicinal dose, and 3 weeks as a course. After two courses, therapeutic effect and drug toxicity side effects were evaluated by measuring positive rate changes of peripheral blood immune cells (CD 4+CD 25+cell), the CD 4+/CD 8+ratio changes, progression-free survival and 3-year survival rate. Results The efifcacy of patients in two groups were evaluated objectively. Observation group of RR and DC were respectively 78.7%and 91.5%, signiifcantly higher than that of control group. To the end of follow-up period, two groups of progression-free surial compared with a signiifcant difference. After two courses of chemotherapy, positive rate of immune cells (CD 4+CD 25+cell) declined had signiifcant difference compared with before treatment. After two courses of chemotherapy, two groups of CD 4+/CD 8+ratio were increased, compared with before treatment, which is a signiifcant difference. The main adverse reactions of the two groups were myelosuppression and neurotoxicity, but there were no termination of tolerance for adverse reactions. Conclusion The programs with paclitaxel plus cisplatin peritoneal perfusion chemotherapy for advanced ovarian cancer which is effective, small toxic and safe, is worthy of clinical application.