摘要
目的:观察自体外周造血干细胞移植(autologous peripherial blod stem cell transplantation,APBSCT)对晚期胃窦癌患者动脉介入化疗的疗效及其对免疫调节因子的影响。方法:40例晚期胃窦癌患者随机分为治疗组和对照组,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48h后接受自体外周造血干细胞移植;对照组只实施同治疗组相同的动脉插管化疗,而无自体外周造血干细胞移植。结果:APBSCT结合动脉介入化疗组与对照组的近期有效率分别是85.0%和70.0%,两组比较差异显著(P<0.01)。前者不良反应显著低于后者(P<0.01),且治疗后其生活质量Karnofsky评分显著高于对照组,其中位生存期、1年生存率分别为24.9±1.36个月和70.0%(14/20)、13.7±0.72个月和35.0%(7/20),治疗组患者中位生存期和1年生存率显著增加(P<0.01);治疗组患者治疗后外周血IL 2、TNF α、IFN γ等细胞免疫调节因子分别为154.8±10.5U/ml、59.4±16.2 U/ml、54.1±13.4 U/ml,显著高于其治疗前水平(54.7±7.2U/ml、43.1±18.8U/ml、16.6±3.7U/ml),亦高于对照组治疗后水平(49.8±26.3U/ml、29.0±11.1U/ml、10.5±6.2U/ml)(P<0.01);治疗组患者治疗后sIL 2R为194.3±67.6 U/ml,比治疗前(819.0±104.5 U/ml)
Objective: To investigate the theraputic effect of super-selective artery chemotherapy in combination with autologous peripheral blood stem cell transplantation and the influences of the modulators of advanced gastric antrum cancer patients. Methods: 40 patients with advanced gastric antrum cancer were divided into treatment group and control group randomly. Autologous peripheral blood stem cell transplantation was transfused in 48 hours after the super-selective left gastric artery chemotherapy, high-dose drugs had been given in the treatment group (EAP scheme was used, VP_ 16100mg/m 2+Epirubicin 60mg/m 2+Carboplatin 200mg/m 2). Only local artery chemotherapy was used in the control group. Results: The results showed that the short stage therapeutic efficacy rate in the treatment group and the control group was 85.0% and 70.0%, respectively(P<0.01). The side effects in the treatment group were significantly lower than that of the control group (P< 0.01). Karnofsky score of life quality of the treatment group was obviously higher than that of the control group. The half survival time and one year survival rate in the treatment group and the control group were 24.9± 1.36 mon, 70.0%(14/20) and 13.7± 0.72 mon, 35.0%(7/20), respectively.Both the half survival time and one-year sunvival rate were significantly improved in the treatment group. The levels of IL-2、TNF-α、IFN-γ after treatment in the treatment group were 154.8± 10.5U/ml、 59.4± 16.2U/ml、 54.1± 13.4U/ml, respectively,which were significantly higher than that before treatment ( 54.7± 7.2U/ml, 43.1± 18.8U/ml and 16.6± 3.7U/ml, respectively),and which were also significantly higher than that after treatment in the control group( 49.8± 26.3U/ml, 29.0± 11.1U/ml and 10.5± 6.2U/ml respectively).On the other hand, the level of immune inhibitor factor sIL-2R after EAP scheme in treatment group was 194.3± 67.6U/ml,it was lower than that before EAP Scheme in the treatment group and that of after EAP scheme in the control group. Conclusion:The high dose super-selective left gastric arterial chemotherapy incombination with autologous peripheral blood stem cell for advanced gastric antrum cancer had good therapeutic efficiacy, its side effects was fewer, the tolerance was much better compared with intravenous chemotherapy, it could significantly improve the life quality, extend the survival period, and improve the survival rate in patients with late gastric antrum cancer. This may be due to the up-regulation of the immune regulating factors such as IL-2, TNF-α, IFN-γ and down-regulation of the immune inhibitory factor sIL-2R after the transplantation of autologous peripheral blood stem cell.
出处
《中国临床医学》
北大核心
2005年第2期224-227,共4页
Chinese Journal of Clinical Medicine
基金
上海交通大学附属第六人民医院胃癌特色专业资助项目
