三胶扶正合剂联合紫杉醇、奈达铂同步放化疗治疗局部晚期非小细胞肺癌的临床观察
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篇名: 三胶扶正合剂联合紫杉醇、奈达铂同步放化疗治疗局部晚期非小细胞肺癌的临床观察
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摘要: 目的:观察三胶扶正合剂联合紫杉醇、奈达铂同步放化疗治疗局部晚期非小细胞肺癌的疗效与安全性。方法:选择我院2015年1月-2017年1月局部晚期非小细胞肺癌患者68例,按随机数字表法分为对照组和观察组,各34例。对照组患者给予紫杉醇注射液135 mg/m2,静脉滴注 ,d1+注射用奈达铂75 mg/m2,静脉滴注,d3,21 d为1个周期,共2个周期;行常规分割调强放疗,每次2 Gy,每周5次,共60~70 Gy;放疗结束后继续给予原方案化疗2个周期。观察组患者在对照组治疗的基础上给予三胶扶正合剂 250 mL/d,分3次服用,至治疗结束。观察两组患者的临床疗效,治疗前后营养指标[体质量指数(BMI)、血清前白蛋白(PAB)、血清白蛋白(ALB)、血红蛋白(Hb)]、肿瘤标志物[鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)、细胞质胸苷激酶1(TK1)、细胞角蛋白 19 片段(CYFRA21-10)水平],并记录不良反应发生情况。结果:两组患者总有效率(观察组82.35% vs. 对照组73.53%)比较,差异无统计学意义(P>0.05)。治疗后,两组患者BMI、PAB、ALB、Hb水平均显著低于同组治疗前,但观察组显著高于对照组;两组患者SCC-Ag、CEA、TK1、CYFRA21-1水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者Ⅲ~Ⅳ度白细胞减少、Ⅰ~Ⅱ度Hb减少及血小板减少发生率均显著低于对照组,差异均有统计学意义(P<0.05)。结论:三胶扶正合剂联合紫杉醇、奈达铂同步放化疗治疗局部晚期非小细胞肺癌的疗效与紫杉醇联合奈达铂同步放化疗相当,但前者可明显改善患者的营养状态,减少不良反应的发生。
ABSTRACT: OBJECTIVE: To observe the efficacy and safety of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin in the treatment of local advanced non-small cell lung cancer (NSCLC). METHODS: A total of 68 patients with local advanced NSCLC selected from our hospital during Jan. 2015 to Jan. 2017 were divided into control group and observation group according to random number table, with 34 cases in each group. Control group was given Paclitaxel injection 135 mg/m2 intravenously, d1+Nedaplatin for injection 75 mg/m2 intravenously, d3, 21 d as a treatment course, for 2 courses;routine fractionated intensity modulated radiation therapy, 2 Gy each time, 5 times a week, 60-70 Gy in total; given 2 cycles of primary chemotherapy continuously after radiotherapy. Observation group was additionally given Sanjiao fuzheng mixture 250 mL/d, divided into 3 times, till the end of treatment, on the basis of control group. Clinical efficacies were observed in 2 groups. The levels of nutritional indexes (BMI, PAB, ALB, Hb) and tumor markers (SCC-Ag, CEA, TK1, CYFRA21-10) before and after treatment were observed. The occurrence of ADR were recorded. RESULTS: There was no statistical significance in the total effective rate between 2 groups (observation group 82.35% vs. control group 73.53%) (P>0.05). After treatment, the levels of BMI, PAB, ALB and Hb in 2 groups were significantly lower than before treatment, but the observation group was significantly higher than the control group. The levels of SCC-Ag, CEA, TK1 and CYFRA21-1 in 2 groups were significantly lower than before treatment, and the observation group was significantly lower than the control group, with statistical significance (P<0.05). The incidence of Ⅲ-Ⅳ degree aleucocytosis,Ⅰ-Ⅱ degree hemoglobin reduction and thrombocytopenia in observation group were significantly lower than control group, with statistical significance (P<0.05). CONCLUSIONS: The efficacy of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin is similar to that of concurrent chemoradiotherapy of paclitaxel and nedaplatin for local advanced NSCLC, which can improve nutritional status significantly, and reduce the incidence of ADR.
期刊: 2018年第29卷第10期
作者: 冉毅,夏冬梅,包中会,任洪波,蒋义,杨吉帆,黄碧有,姚岚,倪燕侠,李少林
AUTHORS: RAN Yi,XIA Dongmei,BAO Zhonghui,REN Hongbo,JIANG Yi,YANG Jifan,HUANG Biyou,YAO Lan,NI Yanxia,LI Shaolin
关键字: 同步放化疗;紫杉醇;奈达铂;三胶扶正合剂;局部晚期非小细胞肺癌;疗效;安全性
KEYWORDS: Concurrent chemoradiotherapy;Paclitaxel; Nedaplatin; Sanjiao fuzheng mixture; Local advanced non-small cell lung cancer; Clinical efficacy; Safety
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