【摘要】 目的观察直肠癌肝转移患者在行化疗~+西妥昔靶向转化治疗的过程中应用脾多肽注射液对其临床疗效、免疫功能及不良反应的影响。方法将2014年1月1日至2016年12月30日我科收治的60例初诊直肠癌肝转移需行转化治疗且基因型为野生型患者随机分为观察组(mFOLFOX6方案化疗~+西妥昔靶向治疗联合脾多肽治疗)和对照组(mFOLFOX6方案化疗~+西妥昔靶向治疗),每组30例。监测患者治疗期间的不良反应、治疗4个周期前、后T细胞亚群、KPS评分的变化及近期临床疗效。结果两组年龄、性别及PS评分及肝转移灶数差异无统计学意义(P> 0.05);观察组治疗有效率为36.7%,对照组治疗有效率为26.7%,两组差异无统计学意义(P> 0.05);观察组骨髓抑制反应发生率低于对照组,两者差异具有统计学意义(P <0.05),两组间的肝肾损伤、腹泻及神经毒性差异无统计学意义(P> 0.05);治疗4个周期后观察组的CD3~+、CD4~+、CD4~+/CD8~+明显高于对照组(P <0.05),CD8~+低于低于对照组(P <0.05),NK细胞百分比变化不明显(P> 0.05);观察组生存质量改善率为80%,对照组为60%,两组差异具有统计学意义(P <0.05)。结论直肠癌肝转移患者术前化疗~+西妥昔靶向治疗过程中同步使用脾多肽注射液能降低相关化疗不良反应,改善患者免疫功能,以及改善患者的生存质量。更多还原

【Abstract】 Objective To observe the effect of splenic polypeptide injection on clinical efficacy,immune function and adverse reactions of patients with rectal cancer liver metastasis in the course of chemotherapy plus cetuximab-targeted transformational therapy. Methods From Jan 1,2014 to Dec 30,2016,60 patients with primary diagnosis of rectal cancer liver metastasis who needed transformational therapy and whose genotype was confirmed as wild type were randomly divided into observation group(m FOLFOX6 regimen plus cetuximate targeted therapy combined with splenic polypeptide therapy,n = 30)and control group(MFOLFOX6 regimen chemotherapy plus cetuximab targeted therapy,n = 30). To monitor the adverse reactions during the treatment,the changes of the T cell subpopulation,the KPS score and the recent clinical curative effect of 4 cycles before and after 4 cycles were treated. Results There were no significant differences in age,gender,PS score,and number of liver metastases between the two groups(P > 0.05). The response rate of the observation group and control group was 36.7% vs. 26.7%,the difference between the two groups was not significant(P > 0.05),and the rate of bone marrow suppression in the observation group was lower than that of the control group. The CD3~+ ,CD4~+ and CD4~+ /CD8~+ of the group after4 cycles were significantly higher(P < 0.05)than those in the control group(P < 0.05). Conclusion The simultaneous use of spleen peptide injection in patients with rectal cancer liver metastasis during preoperative chemotherapy plus cetuxima targeted therapy could reduce adverse reactions induced by chemotherapy,improve patients′ immune function and quality of life.更多还原