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目的:观察黄芪注射液联合新辅助化疗和三维适形放疗治疗大肠癌的临床疗效及安全性。方法:选取我院肿瘤科2010年6月-2014年6月收治的中晚期大肠癌患者80例,按随机数字表法分为观察组和对照组,各40例。对照组给予新辅助化疗联合三维适形放疗,观察组在对照组基础上加用黄芪注射液10~20 mL加入5%葡萄糖注射液250~500 mL中,ivgtt,qd。21 d为1个周期,两组患者共治疗3个周期。观察两组患者近期疗效及治疗前后免疫指标[CD3+、CD4+、CD4+/CD8+和自然杀伤(NK)细胞]的水平,并比较两组患者不良反应的发生情况及生存情况。结果:观察组临床总有效率为87.5%,略高于对照组的77.5%,但差异无统计学意义(P>0.05)。治疗前,两组患者免疫指标水平比较,差异无统计学意义(P>0.05);治疗后,对照组患者NK细胞、CD3+、 CD4+、 CD4+/ CD8+水平显著下降,且显著低于观察组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。观察组患者2年生存率显著高于对照组,复发率及远处转移率均显著低于对照组,差异均有统计学意义(P<0.05)。结论:黄芪注射液能一定程度提高新辅助化疗联合三维适形放疗对大肠癌患者的治疗效果,具有平衡患者炎症状态,提高生存率,降低复发率和远处转移率的作用,且安全性较高。
OBJECTIVE: To observe clinical efficacy and safety of Astragalus injection combined with neoadjuvant chemotherapy and three dimensional conformal radiotherapy in the treatment of colorectal cancer. METHODS: A total of 80 patients with medium and advanced colorectal cancer were selected from oncology department of our hospital during Jun. 2010 to Jun. 2014, and divided into observation group and control group according to random number table, with 40 cases in each group. Control group received neoadjuvant chemotherapy combined with three-dimensional conformal radiotherapy. Observation group was additionally given Astragalus injection 10-20 mL added into 5% Glucose injection 250-500 mL, ivgtt, qd, on the basis of control group. A treatment course lasted for 21 d, and both groups received 3 courses. Short-term efficacies as well as immune indexes [CD3+, CD4+, CD4+/CD8+ and NK cells] before and after treatment were observed in 2 groups. The occurrence of ADR and survival situation were compared between 2 groups. RESULTS: Clinical response rate of observation group was 87.5%, which was slightly higher than that of control group (77.5%), but there was no statistical significance (P>0.05). Before treatment, there was no statistical significance in immune index levels between 2 groups (P>0.05). After treatment, NK cells, CD3+, CD4+ and CD4+/CD8+ levels of control group were decreased significantly, which was significantly lower than observation group, with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). Two-year survival rate of observation group was significantly higher than that of control group; the recurrence rate and distant metastasis rate were significantly lower than control group, with statistical significance (P<0.05). CONCLUSIONS: Astragalus injection not only can improve therapeutic efficacy of neoadjuvant chemotherapy in patients with colorectal cancer, balance inflammatory state, improve survival rate, reduce recurrence rate and distant metastasis rate with good safety.
黄芪注射液大肠癌新辅助化疗三维适形放疗
Astragalus injectionColorectal cancerNeoadjuvant chemotherapyThree dimensional conformal radiotherapy
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