CAJ | 학술논문

目的探讨替莫唑胺联合干扰素治疗晚期黑色素瘤的疗效及安全性。方法68例晚期黑色素瘤患者按随机数字表随机分为治疗组和对照组，各34例，治疗组应用替莫唑胺联合干扰素治疗方案，对照组单独采用替莫唑胺方案。分析和比较两组患者T细胞亚群的变化情况及临床效果。结果治疗组的有效率为64.7％，对照组为38.2％，显著低于治疗组，两组之间差异有统计学意义（P<0.05）；治疗组3、6、12、24个月生存率分别为85.3％、67.6％、41.1％、26.5％，均明显高于对照组的61.8％、44.1％、17.6％、5.9％（P<0.05）。治疗后，治疗组CD3、CD4、CD8、CD4/CD8分别为（69.50±4.62）、（47.03±6.38）、（36.07±6.21）、（1.66±0.78），均明显高于对照组（P<0.05）；治疗组白细胞减少和血小板减少的发生率均显著高于对照组（P<0.05），而两组恶心呕吐，肝、肾功能损害，血红蛋白减少的发生率比较差异无统计学意义（P>0.05）。结论替莫唑胺联合干扰素治疗晚期黑色素瘤的疗效比单用替莫唑胺更好，且不良反应可耐受。
목적탐토체막서알연합간우소치료만기흑색소류적료효급안전성。방법68례만기흑색소류환자안수궤수자표수궤분위치료조화대조조，각34례，치료조응용체막서알연합간우소치료방안，대조조단독채용체막서알방안。분석화비교량조환자T세포아군적변화정황급림상효과。결과치료조적유효솔위64.7％，대조조위38.2％，현저저우치료조，량조지간차이유통계학의의（P<0.05）；치료조3、6、12、24개월생존솔분별위85.3％、67.6％、41.1％、26.5％，균명현고우대조조적61.8％、44.1％、17.6％、5.9％（P<0.05）。치료후，치료조CD3、CD4、CD8、CD4/CD8분별위（69.50±4.62）、（47.03±6.38）、（36.07±6.21）、（1.66±0.78），균명현고우대조조（P<0.05）；치료조백세포감소화혈소판감소적발생솔균현저고우대조조（P<0.05），이량조악심구토，간、신공능손해，혈홍단백감소적발생솔비교차이무통계학의의（P>0.05）。결론체막서알연합간우소치료만기흑색소류적료효비단용체막서알경호，차불량반응가내수。
Objective To explore the curative effects and security of Temozolomide combined with interferon in the treat-ment of advanced melanoma. Methods 68 cases of advanced melanoma patients were randomly divided into the treatment group and control group (34 cases in each group). The treatment group was given Temozolomide combined with interferon, while the control group was treated only by Temozolomide. The changes of T cell subsets and clinical effects as well as adverse reactions were observed and compared between the two groups. Results The effective rate of treatment group and control group were respectively 64.7% and 38.2%; it was significantly higher in the treatment group (P<0.05). The survival rates of treatment group at 3rd, 6th, 12th and 24th month were respectively 85.3%, 67.6%, 41.1%, 26.5%, which were all significantly higher than those in the control group(respectively 61.8%, 44.1%, 17.6%, 5.9%, P<0.05). After treatment, the CD3, CD4, CD8 and CD4/CD8 of treatment group were (69.50±4.62), (47.03±6.38), (36.07±6.21), (1.66±0.78) respectively, all significantly higher than those in the control group (P<0.05). The incidence rates of leukopenia and thrombocytopenia in treatment group were evidently higher than those in the control group (P<0.05), but no significant difference was found in the incidence of nausea and vomiting, liver and kidney damage and decreased hemoglobin (P>0.05). Conclusion Temozolomide combined with interferon was more effec-tive in the treatment of advanced melanoma than Temozolomide alone, and its adverse effects were tolerable.