褪黑素联合化疗对晚期食管癌患者的影响研究

目的 探讨褪黑素联合化疗对晚期食管癌患者的影响,为临床治疗提供依据.方法 选择2011年6月至2013年5月我院收治的40例初治晚期食管癌患者作为研究对象（观察组）,另外选择同期收治的初治晚期食道癌患者40例作为对照组.观察组采用褪黑素联合化疗的方式进行治疗,对照组仅进行化疗,不使用褪黑素.评价两组患者的临床疗效、Karnofsky行为状况评分、外周血中T淋巴细胞亚群的指标.结果 观察组完全缓解10例,占25.00％,部分缓解17例,占42.50％,总有效率为67.5％;对照组完全缓解9例,占22.50％,部分缓解17例,占42.50％,总有效率为65.0％;两组比较差异无统计学意义（P＞0.05）.观察组Karnofsky行为状况评分改善15例,占37.50％,稳定21例,占52.50％,恶化4例,占10.00％,与对照组比较差异有统计学意义（P＜0.05）.观察组CD3＋和CD4＋水平明显高于对照组,差异有统计学意义（P＜0.05）;两组CD8＋水平比较差异无统计学意义（P＞0.05）;观察组CD＋＋/CD8＋比值明显高于对照组,差异有统计学意义（P＜0.05）.结论 褪黑素联合化疗对晚期食管癌患者临床疗效影响不大,但是能够提高免疫力及降低不良反应,在肿瘤辅助治疗中具有增强疗效、降低毒性等作用.

Melatonin in combination with chemotherapy for patients with advanced esophageal cancer

Objective To provide some evidences for trealing advanced esophageal cancer exploring the effect of melatonin in combination with chemotherapy on patients with advanced esophageal cancer. Methods 40 patients with advanced esophageal cancer undergoing initial treatment were selected from our hospital from June, 2011 to May, 2013 as research objects （observation group）. Another 40 patients with advanced esophageal cancer undergoing initial treatment were enrolled into the control group. The observation group was treated with melatonin and chemotherapy, while the control group was treated with only chemotherapy. The clinical efficacies, Karnofsky behavior scores, and the indicators of T lymphocyte subsets in peripheral blood of both groups were evaluated. Results 10 cases （25.00%） got complete remission and 17 cases （42.50%） got partial remission in the observation group with a total effective rate of 67.50%. 9 cases （22.50%） got complete remission and 17 cases （42.50%） got partial remission in the control group with a total effective rate of 65.00%. There was no statistical difference in total effective rate between the two groups （P 〉 0.05）. 15 cases （37.50%） got better, 21 cases （52.50%） were stable, and 4 cases （10.00%） deteriorated in Karnofsky behavior score in the observation group, which were better than that in the control group, with statistical differences （P 〈 0.05）. CD3＋ and CD4＋ levels were significantly higher in the observation group than in the control group, with statistical differences （P 〈 0.05）. There was no statistk：al difference in CD8＋ level between the two groups （P〉O.05）. CD4＋/CD8＋ ratio was significantly higher in the observation group than in the control group, with a statistical difference （P 〈 0.05）. Conclusions Melatonin in combination with chemotherapy has little influence on the clinical curative eft~ct of patients with advanced esophageal cancer, but can improve the patients＇ immunity and reduce adverse reactions, enhance the efficacy in tumor auxiliary treatment, and reduce toxicity effect.