引用本文:蓝必全,张华君,杨迪虹,陈 英,席加喜.胸腺肽联合GP方案治疗晚期非小细胞肺癌的临床疗效和安全性及对免疫功能的影响[J].中国临床新医学,2018,11(9):869-872.
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胸腺肽联合GP方案治疗晚期非小细胞肺癌的临床疗效和安全性及对免疫功能的影响
蓝必全,张华君,杨迪虹,陈 英,席加喜
530021 南宁,广西壮族自治区人民医院肿瘤化疗一区(蓝必全),药学部(张华君,陈 英,席加喜);211198 南京,中国药科大学基础医学与临床药学学院(杨迪虹)
摘要:
[摘要] 目的 观察胸腺肽联合GP方案治疗晚期非小细胞肺癌的临床疗效、安全性及对免疫功能的影响。方法 将114例晚期非小细胞肺癌的患者分为对照组61例和观察组53例。对照组予吉西他滨1 000 mg·m-2静滴,D1、D8联合顺铂75 mg·m-2静滴,21 d为1个周期。观察组在对照组基础上,予胸腺肽注射液20 mg,皮下注射,隔日一次随化疗连续应用2个周期。观察两个周期化疗结束后患者的近期临床疗效、不良反应及T淋巴细胞亚群的变化。结果 观察组临床获益率(86.79%)高于对照组(80.32%)(P<0.05)。观察组客观有效率(37.73%)略高于对照组(32.79%),但差异统计学意义(P>0.05)。观察组血清T淋巴细胞亚群CD3+、CD4+、CD8+和NK细胞计数值明显升高,CD4+/CD8+明显降低(P<0.05)。其临床主要不良反应为血液学毒性和胃肠道反应,观察组化疗后Ⅲ+Ⅳ°白细胞计数、血小板计数减少发生率明显低于对照组(P<0.05),胃肠道反应、肝肾功能等其他不良反应两组间差异统计学意义(P>0.05)。结论 胸腺肽联合GP方案治疗晚期非小细胞肺癌临床疗效良好,能有效提高患者T淋巴细胞亚群水平,降低化疗相关不良反应发生率,提高患者耐受性,临床可进一步研究推广。
关键词:  胸腺肽  非小细胞肺癌  GP方案  临床疗效  免疫功能
DOI:10.3969/j.issn.1674-3806.2018.09.06
分类号:R 97
基金项目:广西壮族自治区食品药品监督管理局2016年食品药品安全科研项目(编号:区直自选0018);广西卫计委科研课题(编号:Z2016610)
Clinical research of thymosin combined with GP regimen in treatment of advanced non-small-cell lung cancer
LAN Bi-quan, ZHANG Hua-jun, YANG Di-hong, et al.
The First Department of Chemotherapy, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
Abstract:
[Abstract] Objective To evaluate the effects of thymosin combined with GP regimen on clinical outcome, safety and immune function in treatment of advanced non-small-cell lung cancer(NSCLC). Methods One hundred and fourteen patients with advanced NSCLC were included in this study and randomly divided into control group(n=61) and treatment group(n=53). The patients in the control group were treated with chemotherapy of gemcitabine 1 000 mg·m-2, day 1, 8+cisplatinum 75 mg·m-2, twenty-one per cycle. The patients in the treatment group received the same treatment as the control group plus thymosin injection 20 mg qod for 2 cycles of the chemotherapy regime. The clinical efficacy, chemotherapy-related toxicities and the changes of T lymphocyte subsets were compared between the two groups after two cycles of the chemotherapy regime. Results The clinical benefit rate of the treatment group(86.79%) was significantly higher than that of the control group(P<0.05). The objective response rate(CBR) of the treatment group(37.73%) was slightly higher than that of the control group(32.79%)(P>0.05). T-lymphocyte cell subsets of CD3+, CD4+ and CD8+ and NK cells in the treatment group were significantly higher than those in the control group(P<0.05). CD4+/CD8+ in the treatment group was significantly higher than that in the control group(P<0.05). Hematologic toxicities and gastrointestinal responses were the main adverse reactions. The incidence rates of Ⅲ+Ⅳ° leukopenia and thrombocytopenia in the treatment group were significantly lower than those in the control group(P<0.05). There were no significant differences in adverse reactions including gastrointestinal reactions and abnormal hepatic and renal functions between the two groups(P>0.05). Conclusion Thymosin combined with GP regimen is effective in treatment of advanced non-small-cell lung cancer. It can elevate the level of T lymphocyte subsets, reduce the chemotherapy-related toxicities and enhance the patients′ tolerance to chemotherapy.
Key words:  Thymosin  Non-small-cell lung cancer(NSCLC)  GP regimen  Clinical efficacy  Immune function