超选择动脉化疗结合中药治疗胃癌患者的近期疗效及其对免疫功能的影响

目的:观察超选择动脉介入化疗结合中药扶正抗癌冲剂治疗晚期胃癌患者的近期疗效及其对免疫功能的影响。方法:80例晚期胃窦癌患者随机分为治疗组和对照组,每组40例,治疗组行超选择高剂量胃左动脉化疗(EAP方案,VP16100mg/m2 表阿霉素60mg/m2 卡铂200mg/m2),并于首次介入化疗48h后口服扶正抗癌冲剂;对照组只采用超选择胃左动脉插管化疗。结果:超选择动脉介入化疗结合中药治疗组与对照组的近期有效率分别是82.5%和57.5%,两组比较差异有统计学意义(P<0.01)。前者毒副反应发生率显著低于后者(P<0.01),且治疗后其生活质量Karnofsky评分显著高于对照组(P<0.05)。两组患者中位生存期、一年生存率分别为(24.9±1.36)个月和70%(28/40)、(13.7±0.72)个月和35%(14/40),治疗组患者中位生存期和一年生存率显著高于对照组(P<0.01);治疗组患者治疗后外周血白细胞介素2(interleukin-2,IL-2)、肿瘤坏死因子α(tumornecrosisfactor-α,TNF-α)、γ干扰素(interferon-gamma,IFN-γ)等细胞免疫调节因子显著高于其治疗前水平(P<0.05或P<0.01),亦高于对照组治疗后水平(P<0.01);治疗组患者治疗后可溶性白介素2受体(solubleinterleukin-2receptor,sIL-2R)比治疗前下降,亦低于对照组治疗后水平(P<0.01)。结论:中药扶正抗癌冲剂支持下的超选择高剂量胃左动脉化疗治疗晚期胃窦癌,近期疗效佳,副反应小,且可显著改善患者的生活质量,提高其中位生存期和生存率,这可能与其治疗后机体免疫功能改善及造血功能及时重建有关。

Immunoregulation and short-term therapeutic effects of super-selective intra-arterial chemotherapy combined with traditional Chinese drugs on gastric cancer patients

OBJECTIVE: To investigate the immunoregulation and short-term therapeutic effects of super-selective intra-arterial chemotherapy combined with Fuzheng Kang'ai Granules, a compound Chinese herbal medicine, on patients with late gastric cancer. METHODS: Forty patients with late gastric antrum cancer were randomly divided into study group and control group. Patients in the study group were orally administered Fuzheng Kang'ai Granules 48 hours after the first super-selective left gastric artery chemotherapy with high-dose drugs (EAP regime: VP(16) 100 mg/m(2) + epirubicin 60 mg/m(2) + carboplatin 200 mg/m(2)), while patients in the control group were only administered the same local artery chemotherapy as in the study group. RESULTS: The short-term therapeutic efficacy in the study group and control group were 82.5% and 57.5% respectively (P<0.01). The occurrence rates of side effects in the study group were significantly lower than those in the control group (P<0.01). The Karnofsky score of life quality of the study group was obviously higher than that of the control group after treatment (P<0.05). The half survival time and one year survival rate in the study group and control group were (24.9 +/- 1.36) month, 70% (28/40) and (13.7 +/- 0.72) month, 35% (14/40) respectively. They were significantly improved in the study group compared with the control group (P<0.01). The levels of cytokines interleukin 2 (IL-2), tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma) after treatment in the study group were significantly higher than those before treatment (P<0.05 or P<0.01), as well as than those after treatment in the control group (P<0.01). On the other hand, the level of immune inhibitory factor soluble interleukin-2 receptor (sIL-2R) after treatment in the study group was lower than that before treatment, as well as than that after treatment in the control group (P<0.01). CONCLUSIONS: The super-selective intra-arterial chemotherapy combined with Fuzheng Kang'ai Granules has good short-term therapeutic efficiency and few side effects for patients with late gastric antrum cancer. It can significantly improve the life quality, extend the survival period, and improve the survival rate in patients with late gastric antrum cancer, which may be due to the up-regulation of the immune regulating factors such as IL-2, TNF-alpha, IFN-gamma and down-regulation of the immune inhibitory factor sIL-2R.