卡培他滨联合替吉奥化疗在胰腺癌术后的临床疗效

[摘 要] 目的 探究胰腺癌患者行手术治疗后卡培他滨联合替吉奥对比卡培他滨单药化疗的临床疗效以及对患者免疫功能的影响。方法 对株洲医院于2008年1月至2010年12月收治的48例行手术治疗后的胰腺癌患者进行前瞻性分析，随机分为对照组和观察组，每组24例，对照组采用卡培他滨单药化疗，观察组采用卡培他滨联合替吉奥化疗。采用生活质量核心量表（QLQ-C30）评估患者生活质量，流式细胞仪检测淋巴细胞亚群，ELISA法检测IFN-γ和IL-4水平，再从脱发、骨髓抑制、肾功能损伤、消化道不良反应和神经毒性五个方面分析两组患者的毒副反应，回访分析两组患者的远期生存率。结果 观察组化疗后缓解率和总有效率分别为41.67%和70.83%，明显高于对照组的25.00%和58.33%；观察组化疗后2周、4周和8周时生活质量均明显优于对照组；以上差异均具有统计学意义（P<0.01）。观察组联合化疗后的T细胞（CD3 + ）、Th细胞（CD3 + CD4 + ）、Tc细胞（CD3 + CD8 + ）、NK细胞（CD3 - CD56 + ）和Treg细胞（CD4 + CD25 + ）百分率增加，IFN-γ水平上升，IL-4水平降低，与化疗前相比，差异均具有统计学意义（P<0.01）。另外，观察组脱发、肾功能损伤、骨髓抑制、消化道不良反应和神经毒性等没有明显增加（P>0.05）。观察组中位生存时间明显长于对照组（25个月 vs 10个月）；观察组的1、2、3年生存率分别为62.5%、54.2%和45.8%，也明显高于对照组（分别为33.3%、25.0%、16.7%），差异具有统计学意义（P<0.05）。结论 卡培他滨联合替吉奥对胰腺癌术后患者具有较高的化疗效果，可显著改善患者的生活质量，提高远期生存率，且不增加不良反应发生率；同时该方式提高机体免疫功能，可成为手术后胰腺癌患者辅助治疗的有效选择。

Clinical efficacy of Capecitabine combined with S-1 chemotherapy in patients with pancreatic cancer after surgical treatment

Abstract objective To investigate the clinical efficacy of Capecitabine combined with S-1 chemotherapy and its effect on immune function in patients with pancreatic cancer after surgical treatment. Methods A total of 48 patients with pancreatic cancer who enrolled in our hospital from Jan. 2008 to Dec. 2010, were randomly divided into control group and observation group. Twenty-four patients in control group were treated with Capecitabine alone, and additional 24 patients in observation group were treated with Capecitabine plus S-1 chemotherapy. Lymphocyte subsets was detected by flow cytometry, and the levels of IFN-γ and IL-4 were detected by ELISA. Furthermore, the life quality, side effects and long-term survival rate were also analyzed. Results The remission rate and total effective rate in the observation group were 41.67% and 70.83%, respectively, which were significantly higher than those in the control group (25.00% and 58.33%) (P<0.01). Thelife quality in the observation group was significantly better than that in the control group at 2, 4 and 8 weeks after chemotherapy (P<0.01). The proportion of T cells (CD3 + ), Th cells (CD3 + CD4 + ), Tc cells (CD3 + CD8 + ), NK cells (CD3 - CD56 + ) and Treg cells (CD4 + CD25 + ) all increased, and the level of IFN-γ also increased, but the level of IL-4 decreased in the observation group after chemotherapy (P<0.01). In addition, there was no significant increase in the side effects of hair loss, renal injury, myelosuppression, gastrointestinal adverse reactions and neurotoxicity in the observation group (P>0.05). The median survival time in the observation group was significantly longer than that in the control group (25.00 months vs 10.00 months, P<0.05); the 1, 2, and 3 year survival rates in the observation group were 62.5%, 54.2% and 45.8%, respectively, which were significantly higher than those in the control group (33.3%, 25.0%, 16.7%, respectively; P<0.05). Conclusion Capecitabine combined with S-1 has a high therapeutic effect on postoperative patients with pancreatic cancer, which can improve the life quality, long-term survival rate, and the immune function, and which does not increase the incidence of adverse reactions. Thisprogramme may become an effective choice for patients with pancreatic cancer after surgery.