紫杉醇联合洛铂经介入栓塞给药化疗宫颈癌的临床观察
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篇名: 紫杉醇联合洛铂经介入栓塞给药化疗宫颈癌的临床观察
TITLE:
摘要: 目的:探讨紫杉醇联合洛铂经介入栓塞给药对宫颈癌患者的化疗疗效和安全性。方法:选取我院2010年5月-2014年3月收治的宫颈癌患者68例,按照治疗方案分为对照组和观察组,各34例。对照组患者给予注射用紫杉醇脂质体175 mg/m2加至5%葡萄糖注射液250 mL,ivgtt+注射用洛铂80 mg/m2加至5%葡萄糖注射液250 mL,ivgtt;观察组患者采用动脉穿刺插管经动脉造影选取子宫动脉和肿瘤血管,以明胶海绵栓塞,同时经穿刺导管注入注射用紫杉醇脂质体175 mg/m2+注射用洛铂80 mg/m2+5%葡萄糖注射液10 mL。两组患者均在每个疗程第1天给药,以21 d为1个疗程,共治疗3个疗程。观察两组患者临床疗效、治疗前后T淋巴细胞亚群(CD4+、CD8+、CD4+/CD8+)水平;记录治疗过程中不良反应发生情况、治疗2年后的局部复发与转移情况,以及生存情况。结果:观察组患者治疗总有效率(85.29%)明显高于对照组(61.76%),差异有统计学意义(P<0.05)。治疗前,两组患者CD4+、CD8+和CD4+/CD8+水平比较,差异均无统计学意义(P>0.05);治疗后,两组患者CD4+和 CD4+/CD8+水平均明显升高,CD8+水平明显降低,且观察组患者上述水平改善较对照组明显,差异均有统计学意义(P <0.05)。观察组患者生存时间[(22.58±0.61)个月]明显长于对照组[(17.61±1.32)月],2年生存率(70.59%)明显高于对照组(47.06%),差异均有统计学意义(P<0.05)。两组患者的疾病控制率、总不良反应发生率、局部复发与转移率比较,差异均无统计学意义(P>0.05)。结论:紫杉醇联合洛铂经介入栓塞给药对宫颈癌患者的化疗疗效明确,可改善其T淋巴细胞亚群水平,且安全性较高。
ABSTRACT: OBJECTIVE: To investigate chemotherapeutic efficacy and safety of Paclitaxel combined with lobaplatin by interventional embolization for cervical cancer. METHODS: Totally 68 cases of cervical cancer patients selected from our hospital during May 2010-Mar. 2014 were divided into control group and observation group according to therapy plan, with 34 cases in each group. Control group was given Paclitaxel liposome for injection 175 mg/m2 added into 5% Glucose injection 250 mL, ivgtt+Lobaplatin for injection 80 mg/m2 added into 5% Glucose injection 250 mL, ivgtt. Observation group was given Paclitaxel liposome for injection 175 mg/m2+Lobaplatin for injection 80 mg/m2+5% Glucose injection 10 mL via percutaneous catheter after selecting uterine artery and tumor vessel by arterial catheterization arteriography, gelfoam embolization. Both groups were treated in the first day of every treatment course, 21 d as a treatment course, for 3 courses. Clinical efficacies were observed in 2 groups as well as the levels of T lymphocyte subsets (CD4+, CD8+, CD4+/CD8+) before and after treatment. The occurrence of ADR during treatment, local recurrence and metastasis after 2 years, and survival situation were recorded. RESULTS: The total response rate of observatio group (85.29%) was significantly higher than that of control group (61.76%), with statistical significance (P<0.05). Before treatment, there was no statistical significance in the levels of CD4+, CD8+ or CD4+/CD8+ between 2 groups (P>0.05). After treatment, CD4+ and CD4+/CD8+ of 2 groups were increased significantly, while CD8+ was decreased significantly; above indexes of observation group were improved significantly compared to control group, with statistical significance (P<0.05). The survival time of observation group [(22.58±0.61)months] was significantly longer than that of control group [(17.61±1.32)months], and 2-year survival rate (70.59%) was significantly higher than control group (47.06%), with statistical significance (P<0.05). There were no statistical significance in incidence of disease control, incidence of total ADR and incidence of local recurrence and metastasis between 2 groups (P>0.05).  CONCLUSIONS: Paclitaxel combined with lobaplatin by interventional embolization show definite chemotherapeutic efficacy for cervical cancer, and can improve the levels of T lymphocyte subset with good safety.
期刊: 2017年第28卷第17期
作者: 刘静,余梦红,张丛敏,刘星,钱莹,陈益波
AUTHORS: LIU Jing,YU Menghong,ZHANG Congmin,LIU Xing,QIAN Ying,CHEN Yibo
关键字: 紫杉醇;洛铂;介入栓塞;宫颈癌;T淋巴细胞亚群;安全性
KEYWORDS: Paclitaxel; Lobaplatin; Interventional embolization; Cervical cancer; T lymphocyte subset; Safety
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