鸦胆子油乳联合GP方案治疗中晚期非小细胞肺癌的临床研究

目的:根据检测ERCC1表达类型,分组观察鸦胆子油乳注射液配合GP方案化疗治疗中晚期非小细胞肺癌的疗效。方法:免疫组织化学检测非小细胞肺癌患者ERCC1表达情况,ERCC1(-)56例机械抽样法分为治疗组和对照组,各28例,ERCC1(+)48例机械抽样法分为治疗组和对照组,各24例。2个治疗组采用鸦胆子油乳注射液联合GP方案化疗,2个对照对照组单用GP方案化疗。21天为1周期,连续4个周期后评价疗效。结果:ERCC1(-)、ERCC1(+)中的治疗组骨髓抑制作用显著低于其对照组(P0.05),生活质量(KPS评分)及细胞免疫功能高于其对照组(P0.05);ERCC1(-)治疗组TTP为(26.4±9.5)个月,对照组为(20.6±8.6)个月,两组比较有显著性差异(P0.05)。ERCC1(+)治疗组TTP为(19.5±6.4)个月,对照组为(15.2±7.5)个月,两组比较有显著性差异(P0.05)。ERCC1(-)治疗组与ERCC1(+)治疗组比较,ERCC1(-)对照组与ERCC1(+)对照组比较,均有显著性差异(P0.05).治疗后ERCC1(-)、ERCC1(+)两个治疗组CD3、CD4、CD8、CD4/CD8显著高于其对照组治疗后。ERCC1(-)治疗组临床控制率为85.7%,对照组为67.9%,两组比较存在显著性差异(P0.05);ERCC1(+)治疗组临床控制率为62.5%,对照组为45.8%,两组比较有显著性差异(P0.05)。结论:鸦胆子油注射液预处理对化疗有提高生活质量,保护免疫功能,减轻骨髓抑制,提高临床控制率,延长TTP的作用。ERCC1(+)非小细胞肺癌患者对顺铂方案有耐药性,应用免疫组织化学方法检测ERCC1表达水平,临床上可作为GP化疗方案方案化疗的敏感性及其预后的预测指标之一。

Clinical Study on the Treatment of Non-small-cell Lung Cancer with Brucea Fruitwater in Oil Emuision Combined with GP Shemotherapy Regimen in the Treatment of Different Types of ERCC1 Expression in Patients

Objective: According to the detection of ERCC1 expression types,observe the curative effects on non-small-cell lung cancer with GP chemotherapy regimen and brucea fruitwater in oil emuision.Methods: Immunohistochemical detection of non small cell lung cancer patients treated with ERCC1expression.ERCC1(-) in 56 cases of mechanical sampling method is divided into treatment group and control group,28 cases in each.ERCC1(+) in 48 cases of mechanical sampling method is divided into treatment groups and control group,24 cases in each.The two treatment groups with brucea fruitwater in oil emuision combined with GP regimen chemotherapy,the two control groups only with GP scheme chemotherapy.Results: The bone marrow inhibition of both treatment groups in ERCC1(-) group and ERCC1(+) group was significantly less than that of the two control groups(P<0.05).Lfe quality scores of Karnofsky and cell immune function in both treatment goups were also higher than those of the two control groups(P<0.05).ERCC1(-) TTP in treatment group was(26.4±9.5)months,the control group was(20.6±8.6)months,there were significant differences between two groups(P< 0.05).ERCC1(+) TTP in treatment group was(19.5±6.4)months,the control group was(15.2±7.5)months,there were significant differences between two groups(P< 0.05).Between ERCC1(-) group and ERCC1(+) treatment group,between ERCC1(-) group and ERCC1(+) compared to the control group,there were significant differences in TTP(P<0.05).After treatment,CD3,CD4,CD8,CD4/CD8 in two treatment groups of ERCC1(-),ERCC1(+) were significantly higher than those of both the control groups.The clinical response rate in ERCC1(-) treatment group was 85.7%,and that was 67.9% in its control group,there was a significant difference between the two groups(P< 0.05).The clinical response rate in ERCC1(+) treatment groupwas 62.5%,and that was 45.8% in its control group,there were significant differences between two groups(P< 0.05).Conclusion: Treating with brucea fruitwater in oil emulsion before GP chemotherapy regimen,which benefits patiens with non-small-cell lung cancer for improving their life quality,protecting immune functins,reducing marrow suppression,raising clinical response rate and protract TTP.ERCC1(+) in patients with non-small cell lung cancer with resistance to cisplatin,as the application of immunohistochemistry to detect the expression level of ERCC1,clinically available as GP regimen chemotherapy sensitivity and its prognostic indicator.