参芪扶正加同步放化疗治疗局部晚期非小细胞肺癌的临床研究

目的观察参芪扶正注射液联合同步放化疗对局部晚期非小细胞肺癌的治疗效果。方法将67例局部晚期非小细胞肺癌患者随机分为两组,综合组36例,采用依托泊苷+顺铂同步放化疗,放疗予常规分割,2 Gy/f,总量56~70 Gy,同时应用参芪扶正注射液250 mL/d静脉滴入,2周为1个疗程,共2个疗程。对照组31例,采用依托泊苷+顺铂同步放化疗。放疗结束后1个月评价疗效;分别于治疗前,治疗后1天,治疗后1月抽取患者外周血,采用流式细胞术检测患者外周血中T细胞亚群百分率(CD3+;CD4+、CD8+、CD4+/CD8+)及NK细胞含量变化观察免疫功能变化;通过KPS评分,体重变化来观察生存质量改善情况。结果 2组有效率分别为75%和70.9%(P0.05);2组治疗前免疫功能差异无统计学差异(P0.05),与本组治疗前相比,综合组治疗后一天测免疫功能稍下降(P0.05)而对照组明显下降(P0.01),综合组治疗后一月明显改善(P0.05)对照组有改善(P0.05);综合组3~4级血液学毒性的发生率为13.9%明显低于对照组的35.5%(P0.05),综合组3~4级消化道不良反应以及≥2级放射性食管炎、肺炎发生率均低于对照组(P0.05);综合组治疗后KPS评分及体重评分改善人数明显高于对照组(P0.05)。结论参芪扶正注射液联合同步放化疗可以减轻放化疗引起的胃肠道反应,减少3~4级骨髓抑制和≥2级放射性食管炎、肺炎的发生,使患者的免疫功能、生存质量得到改善,并有可能进一步提高局部晚期非小细胞肺癌同步放化疗的疗效。

Shenqifuzheng injection combined with concurrent chemoradiotherapy in the treatment of locally advanced non-small cell lung cancer

Objective To evaluate the clinical toxicity and efficacy of Shenqifuzheng injection combined with concurrent chemoradiotherapy in the treatment of locally advanced non-small cell lung cancer.Methods Sixty-seven patients with locally advanced non-small cell lung cancer were randomized into tuo groups.The combination group received chemotherapy of etoposide and cisplatin regimen,and radiotherapy was given with conventional fraction in 2Gy per fraction and five fractions per week.The total tumor doses were 56～70 Gy.Combined with Shenqifuzheng injection 250 mL/d for two consecutive weeks for two courses,and the control group was given chemoradiotherapy only.Toxicities and effects were evaluated according to the criteria of WHO.Results Response rate of the combination group was 75% and 70.9% in the control group(P>0.05).The difference of immune functions in two groups before treatment was not statistically significant(P>0.05).But affer treatmnt,immune function sightly decreased in the combination group(P>0.05) while the control group decreased significantly(P<0.01).The immune function of the slintegrated group improved more significantly a month after treatment(P<0.05) than that in the control group(P>0.05).Grade 3～4 leukocytopenia in hematologic toxicity rate in the integrated group was 13.9%,significantly lower than that in the control group 35.5%(P<0.05).of 3 to 4 gastrointestinal adverse reactions,≥2 grade radioactive esophagitis,and pneumonia incidence in the integrated group were lower than those in the control group(P>0.05);KPS score and body weight of the combination group after treatment were significantly higher than those in the control group(P<0.05). Conclusion Shenqifuzheng injection combined with concurrent chemoradiotherapy can relieve side effects of chemoradiotherapy in the treatment of locally advanced non-small cell lung cancer,and improve life quality.Shenqifuzheng may increase efficacy of concurrent chemoradiothrapy for locally advanced non-small cell lung cancer.