CAJ | 학술논문

目的:探讨序贯甘露聚糖肽联合同步放化疗治疗IV期非小细胞肺癌的临床疗效和安全性.方法:2005年2月~2011年3月期间非小细胞肺癌患者72例,随机分为试验组和对照组,各36例,试验组患者在同步放化疗基础上应用甘露聚糖肽序贯治疗,对照组患者在同步放化疗基础上应用胸腺肽序贯治疗.观察患者治疗前后免疫学指标的变化和治疗期间不良反应,并治疗结束后随访5年.结果:两组患者治疗前CD4+、CD8+、CD4+/CD8+、C3、WBC、N、IgA、IgG、IgM等各项指标比较无统计学差异(P>0.05).两组治疗后2个月和治疗结束时CD4+、CD8+、CD4+/CD8+均高于治疗前,而两组治疗后2个月C3、WBC、N、IgA、IgG、IgM较治疗前明显下降(P<0.05),并随治疗时间的延长逐渐回升.试验组患者治疗后各项指标均高于对照组,其中结束时各项指标与对照组比较具有统计学意义(P<0.05).尤其外周血WBC、N指标与同期对照组比较具有极显著差异(P<0.001)治疗结束时试验组有效率为58.33%,高于对照组的44.44%,但两组比较差异无统计学意义(χ2=1.39,P=0.24).治疗组中位生存期为14.75个月,对照组中位生存期为12.97个月,两组比较差异具有统计学意义(P=0.017).两组卡氏评分比较中,治疗组有效率为88.89%,明显高于对照组的66.67%.两组比较差异具有统计学意义(χ2=5.14,P=0.023).两组患者治疗期间均有常见放化疗反应,但试验组患者不良反应发生率明显低于对照组(P=0.0046).结论:甘露聚糖肽序贯疗法联合同步放化疗治疗IV期非小细胞肺癌,能改善患者免疫功能,提高放化疗临床疗效,减轻放化疗的毒副作用,改善生存质量,延长生存期.
목적:탐토서관감로취당태연합동보방화료치료IV기비소세포폐암적림상료효화안전성.방법:2005년2월~2011년3월기간비소세포폐암환자72례,수궤분위시험조화대조조,각36례,시험조환자재동보방화료기출상응용감로취당태서관치료,대조조환자재동보방화료기출상응용흉선태서관치료.관찰환자치료전후면역학지표적변화화치료기간불량반응,병치료결속후수방5년.결과:량조환자치료전CD4+、CD8+、CD4+/CD8+、C3、WBC、N、IgA、IgG、IgM등각항지표비교무통계학차이(P>0.05).량조치료후2개월화치료결속시CD4+、CD8+、CD4+/CD8+균고우치료전,이량조치료후2개월C3、WBC、N、IgA、IgG、IgM교치료전명현하강(P<0.05),병수치료시간적연장축점회승.시험조환자치료후각항지표균고우대조조,기중결속시각항지표여대조조비교구유통계학의의(P<0.05).우기외주혈WBC、N지표여동기대조조비교구유겁현저차이(P<0.001)치료결속시시험조유효솔위58.33%,고우대조조적44.44%,단량조비교차이무통계학의의(χ2=1.39,P=0.24).치료조중위생존기위14.75개월,대조조중위생존기위12.97개월,량조비교차이구유통계학의의(P=0.017).량조잡씨평분비교중,치료조유효솔위88.89%,명현고우대조조적66.67%.량조비교차이구유통계학의의(χ2=5.14,P=0.023).량조환자치료기간균유상견방화료반응,단시험조환자불량반응발생솔명현저우대조조(P=0.0046).결론:감로취당태서관요법연합동보방화료치료IV기비소세포폐암,능개선환자면역공능,제고방화료림상료효,감경방화료적독부작용,개선생존질량,연장생존기.
Objective:To investigate the clinical efficacy and safety of mannatide sequential therapy combined with synchronous radiotherapy and chemotherapy in the treatment of stage IV non-small cell lung cancer.Methods:72 patients with non-small cell lung cancer were randomly divided into experimental and control groups,which consisted 36 cases respectively.The patients in experimental group were treated with synchronous radiotherapy and chemotherapy combined with mannatide sequential,and the control group patients with synchronous radiotherapy and chemotherapy combined with thymopeptide sequential therapy.Immunological parameters of patients were observed before and after treatment,and adverse reactions were watched during treatment and in the end of treatment and follow-up of 5 years.Results:Immunological parameters of CD4+,CD8+,CD4+/CD8+,C3,WBC,N,IgA,IgG,IgM in patients showed no significant difference (P>0.05) before treatment.After 2 months treatment and at the end of and treatment,the levels of CD4+,CD8+,CD4+/CD8+ of two groups were higher than levels before treatment;While after 2 months treatment,C3,WBC,N,IgA,IgG,IgM of the two groups significantly decreased compared with prior treatment (P<0.05) and recovered gradually in the duration of treatment.Compared with the control group,indexes in the treatment group patients were higher,and had a statistically significant (P<0.05).And WBC,N of treatment had a very significant difference (P<0.001) compared with the same period in the control group.After treatment,the experimental group effective rate of 58.33% was higher than that of the control group (44.44%),but the two groups showed no significant difference (χ2=1.39,P= 0.24). The treatment group had a median survival of 14.75 months and it was significantly better than the control group 12.97 months (P=0.017). In Karnofsky comparison of two groups,it was 88.89% for the treatment group and significantly higher than control group 66.67%.Both groups patients appeared radiotherapy and chemotherapy side effects during treatment,but the incidence of adverse reactions of the test group patients was significantly lower than the control group (P=0.0046).Conclusion:Mannatide sequential therapy combined with synchronous radiotherapy and chemotherapy in the treatment of stage IV non-small cell lung cancer could improve immune function of patients and the clinical efficacy of radiotherapy and chemotherapy,reduce the side effects of radiotherapy and chemotherapy,improve the quality of life and prolong survival time.