摘要
目的 探讨晚期非小细胞肺癌患者行冷冻消融序贯化疗的效果及生活质量、免疫功能的改善情况。方法 160例晚期非小细胞肺癌患者随机分为观察组和对照组各80例,对照组给予GP方案（吉西他滨＋顺铂）化疗,21d为1个周期,连续3个周期;观察组GP方案化疗药物用法用量同对照组,并于化疗前1周给予冷冻消融治疗。化疗3个周期后评定2组近期疗效,随访12~36个月观察2组无进展生存时间、总生存时间,并分别于治疗前及疗程结束后4周应用生活质量综合评定量表评定患者生活质量,测定血清白细胞介素（interleukin,IL）-6、IL-10,肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）、干扰素γ（interferon-γ,IFN-γ）水平。结果 2组均完成规定周期化疗,观察组客观有效率（65.00%）和疾病控制率（91.25%）均高于对照组（47.50%,76.25%）（P〈0.05）;随访至2015年4月,观察组无进展生存时间[（13.43±1.85）个月]和总生存时间[（33.28±5.24）个月]较对照组[（7.65±0.93）、（24.17±2.57）个月]长（P〈0.05）;2组治疗后生活质量均较治疗前改善,观察组治疗后物质生活维度评分（54.27±6.13）、躯体健康维度评分（65.28±8.24）、心理健康维度评分（65.21±7.43）、社会功能维度评分（62.22±8.87）均高于对照组（46.34±4.43、52.23±6.17、51.56±6.89、50.68±7.02）（P〈0.05）;2组治疗后IL-6、IL-10均较治疗前降低,TNF-α、IFN-γ较治疗前增高（P〈0.05）;观察组治疗后血清IL-6[（56.81±6.91）μg/L]、IL-10[（28.63±3.02）μg/L]水平低于对照组[（78.62±8.81）、（36.42±5.92）μg/L],TNF-α[（61.31±8.52）μg/L]、IFN-γ[（52.28±6.35）μg/L]水平高于对照组[（42.52±5.31）、（40.85±5.21）μg/L]（P〈0.05）。结论 GP方案化疗联合冷冻消融治疗可提高晚期非小细胞肺癌治疗效果,改善患者免疫功能,延长生存时间,提高生活质量。
Objective To study the effect of cryosurgery sequential chemotherapy on the result, quality of life and immunity in the patients with advanced non-small cell lung cancer （NSCLC）. Methods A total of 160 patients with advanced NSCLC were randomly divided into observation group and control group, with 80 patients in each group. Control group received GP scheme （gemcitabine ＋ cispiatin）, 21 days as a cycle, totally for 3 cycles, and observation group received cryosurgery sequential chemotherapy one week before GP scheme. After 3 cycles of chemotherapy, the short-term effects were compared between two groups. The progression-free survival time and total survival time were observed during 12- to 36-month follow-up survey. Before and 4 weeks after treatment, the quality of life rating scale was used to assess patients＇ quality of life, and the levels of interleukin （IL）-6, IL-10, tumor necrosis factor-α （TNF-α and interferon-γ （IFN-γ） were detected. Results All patients completed chemotherapy cycles. The objective response rate and disease control rate were significantly higher in observation group （65.00%, 91.25%） than those in control group （47.50%, 76.25%） （P〈0.05）. All patients were followed up to April 2015, progression free survival and overall survival time were longer in observation group （（13.43 ± 1.85）, （33.28±5.24） months） than those in control group （（7.65±0.93）, （24. 17±2.57） months） （P〈0.05）. After treatment, the quality of life was improved in both two groups. The material life score （54. 27±6. 13）, physical health score （65. 28 ± 8.24）, mental health score （65.21± 7.43）, and social function score （62.22±8.87） were significantly higher in observation group than those in control group （46.34±4.43, 52.23±6.17, 51.56±6.89, 50.68±7.02） （P〈0.05）. After treatment, the levels of IL-76 and IL -10were lower, and the levels of TNF-α and IFN-γ were higher in observation group IL-6 （IL-6： （56. 81 ± 6,
出处
《中华实用诊断与治疗杂志》
2015年第10期1028-1030,共3页
Journal of Chinese Practical Diagnosis and Therapy
关键词
晚期非小细胞肺癌
化疗
冷冻消融
生活质量
免疫功能
Non-small cell lung cancer
thermotherapy
cryoablation
life quality
immune function
