中国医药
中國醫藥
중국의약
CHINA MEDICINE
2015年
1期
8-12
,共5页
楼君%盛誉%凌今%袁霞妹%吴闵丽%汤婉芬
樓君%盛譽%凌今%袁霞妹%吳閔麗%湯婉芬
루군%성예%릉금%원하매%오민려%탕완분
癌,非小细胞肺%人类平衡型核苷转运蛋白1%吉西他滨%剂量
癌,非小細胞肺%人類平衡型覈苷轉運蛋白1%吉西他濱%劑量
암,비소세포폐%인류평형형핵감전운단백1%길서타빈%제량
Carcinoma,Non small cell lung%Human equilibrative nucleoside transporter 1%Gemcitabine%Dose
目的 观察晚期非小细胞肺癌(NSCLC)中人类平衡型核苷转运蛋白1(hENT1)高表达患者应用不同剂量吉西他滨治疗的临床效果.方法 选取2008年7月至2013年12月于浙江金华广福医院行晚期NSCLC手术后,病理确诊晚期NSCLC患者,采用免疫组织化学SP法检测肺癌组织中hENT1抗体的表达水平.62例hENT1高表达患者入组,按随机数字表分组法分为对照组(30例)和观察组(32例).对照组采用常规剂量吉西他滨(1 000 mg/m2)联合顺铂进行化疗,观察组用低剂量吉西他滨(250 mg/m2)联合顺铂进行化疗,观察2组近期疗效、化疗不良反应.采用生活质量调查核心量表QLQ-C30和肺癌专用量表QLQ-LCl3比较2组化疗后生活质量.结果 对照组和观察组近期有效率和疾病控制率差异无统计学意义[43.3％ (13/30)比46.9％ (15/32),76.9％ (23/30)比81.2％(26/32)](x2 =0.08,x2 =0.20,P＞0.05).观察组Ⅲ、Ⅳ度白细胞减少、血小板减少及恶心、呕吐发生率低于对照组,差异有统计学意义(P＜0.05);除角色功能外,观察组化疗后总体生活评分及躯体功能、情绪功能、认知功能、社会功能、经济状况各项评分均优于对照组[(54±20)分比(54±16)分,(72±25)分比(62 ±20)分、(85 ±20)比(72±19)分、(76±28)分比(62±25)分、(61 ±24)分比(49 ±30)分、(36±24)分比(56±21)分],差异均有统计学意义(均P＜0.05).观察组除乏力症状外其他症状评分均优于对照组(P＜0.05).结论 对于晚期NSCLC术后hENT1高表达患者,在保证化疗效果的同时,相对于常规剂量吉西他滨,低剂量用药可有效降低化疗过程中不良反应,提高患者的生活质量.
目的 觀察晚期非小細胞肺癌(NSCLC)中人類平衡型覈苷轉運蛋白1(hENT1)高錶達患者應用不同劑量吉西他濱治療的臨床效果.方法 選取2008年7月至2013年12月于浙江金華廣福醫院行晚期NSCLC手術後,病理確診晚期NSCLC患者,採用免疫組織化學SP法檢測肺癌組織中hENT1抗體的錶達水平.62例hENT1高錶達患者入組,按隨機數字錶分組法分為對照組(30例)和觀察組(32例).對照組採用常規劑量吉西他濱(1 000 mg/m2)聯閤順鉑進行化療,觀察組用低劑量吉西他濱(250 mg/m2)聯閤順鉑進行化療,觀察2組近期療效、化療不良反應.採用生活質量調查覈心量錶QLQ-C30和肺癌專用量錶QLQ-LCl3比較2組化療後生活質量.結果 對照組和觀察組近期有效率和疾病控製率差異無統計學意義[43.3％ (13/30)比46.9％ (15/32),76.9％ (23/30)比81.2％(26/32)](x2 =0.08,x2 =0.20,P＞0.05).觀察組Ⅲ、Ⅳ度白細胞減少、血小闆減少及噁心、嘔吐髮生率低于對照組,差異有統計學意義(P＜0.05);除角色功能外,觀察組化療後總體生活評分及軀體功能、情緒功能、認知功能、社會功能、經濟狀況各項評分均優于對照組[(54±20)分比(54±16)分,(72±25)分比(62 ±20)分、(85 ±20)比(72±19)分、(76±28)分比(62±25)分、(61 ±24)分比(49 ±30)分、(36±24)分比(56±21)分],差異均有統計學意義(均P＜0.05).觀察組除乏力癥狀外其他癥狀評分均優于對照組(P＜0.05).結論 對于晚期NSCLC術後hENT1高錶達患者,在保證化療效果的同時,相對于常規劑量吉西他濱,低劑量用藥可有效降低化療過程中不良反應,提高患者的生活質量.
목적 관찰만기비소세포폐암(NSCLC)중인류평형형핵감전운단백1(hENT1)고표체환자응용불동제량길서타빈치료적림상효과.방법 선취2008년7월지2013년12월우절강금화엄복의원행만기NSCLC수술후,병리학진만기NSCLC환자,채용면역조직화학SP법검측폐암조직중hENT1항체적표체수평.62례hENT1고표체환자입조,안수궤수자표분조법분위대조조(30례)화관찰조(32례).대조조채용상규제량길서타빈(1 000 mg/m2)연합순박진행화료,관찰조용저제량길서타빈(250 mg/m2)연합순박진행화료,관찰2조근기료효、화료불량반응.채용생활질량조사핵심량표QLQ-C30화폐암전용량표QLQ-LCl3비교2조화료후생활질량.결과 대조조화관찰조근기유효솔화질병공제솔차이무통계학의의[43.3％ (13/30)비46.9％ (15/32),76.9％ (23/30)비81.2％(26/32)](x2 =0.08,x2 =0.20,P＞0.05).관찰조Ⅲ、Ⅳ도백세포감소、혈소판감소급악심、구토발생솔저우대조조,차이유통계학의의(P＜0.05);제각색공능외,관찰조화료후총체생활평분급구체공능、정서공능、인지공능、사회공능、경제상황각항평분균우우대조조[(54±20)분비(54±16)분,(72±25)분비(62 ±20)분、(85 ±20)비(72±19)분、(76±28)분비(62±25)분、(61 ±24)분비(49 ±30)분、(36±24)분비(56±21)분],차이균유통계학의의(균P＜0.05).관찰조제핍력증상외기타증상평분균우우대조조(P＜0.05).결론 대우만기NSCLC술후hENT1고표체환자,재보증화료효과적동시,상대우상규제량길서타빈,저제량용약가유효강저화료과정중불량반응,제고환자적생활질량.
Objective To observe the clinical effect of different doses of gemcitabine chemotherapy for patients with high expression of human equilibrative nucleoside transporter 1 (hENT1) after advanced non-smallcell lung cancer(NSCLC) operation.Methods Advanced NSCLC patients were selected in our hospital from July 2008 to December 2013,and advanced NSCLC with pathological diagnosis after operation,making the tumor tissue into paraffin block specimens,testing the expression level of hENT1 antibody by immunohistochemical SP method.62 cases with high expression of hENT1 were divided into two groups by the completely random digit grouping method,the control group were given chemotherapy with routine dose of gemcitabine combined with cisplatin,the observation group were given chemotherapy with low dose gemcitabine combined with cisplatin,the quality of life,curative effect and toxic and side reaction were observed in the two groups after chemotherapy.Results The shortterm effective rate and the disease control rate had no significant differences between the observation group and the control group[46.9％ (15/32) vs 43.3％ (13/30),81.2％ (26/32) vs 76.9％ (23/30)] (x2 =0.08,x2 =0.20,all P ＞ 0.05) ; the Ⅲ,Ⅳ side effects were compared between two groups after chemotherapy,the observation group was better than the control group in leukopenia,thrombocytopenia,nausea,vomiting,and there is a statistically significant difference(P ＜0.05) ; the quality life was compared between two groups after chemotherapy with quality of life questionnaire core scale QLQ-C30 and lung cancer specific scale QLQ-LC13.Except role function,the total score of quality of life,physical function,emotional function,cognitive function,social function and economic conditions in the observation group were better than those in the control group [(54 ± 20)scores vs (54 ± 16) scores,(72 ± 25) scores vs (62 ± 20) scores,(85 ± 20) scores vs (72 ± 19) scores,(76 ± 28) scores vs (62 ± 25) scores,(61 ± 24) scores vs (49 ± 30) scores,(36 ± 24) scores vs (56 ± 21) scores],the difference was statistically significant(P ＜ 0.05).The other symptom scores of observation group were better than the control group except fatigue (P ＜ 0.05).Conclusion While maintaining the equal chemotherapy effect compared with routine dose of gemcitabine and for patients with high expression of hENT1 after advanced NSCLC operation,using low dose gemcitabine can effectively reduce the toxic side reaction and improve the patients' quality life in chemotherapy process.
