复方苦参注射液联合特瑞普利单抗及铂类化疗方案对中晚期前列腺癌的应用效果及免疫功能影响
Effect and immune function of compound matrine injection combined with toripalimab and platinum-based chemotherapy in patients with advanced prostate cancer
谢英瑛 1任英红 1闫家文2
作者信息
- 1. 商洛市中心医院肿瘤科 陕西 商洛 726000
- 2. 商洛市中心医院泌尿外科 陕西 商洛 726000
- 折叠
摘要
目的 探讨复方苦参注射液联合特瑞普利单抗及铂类化疗方案对中晚期前列腺癌的应用效果及免疫功能的影响.方法 前瞻性选取2019年3月至2021年3月在商洛市中心医院诊治的中晚期前列腺癌90例作为研究对象.根据随机数字表法患者分为单用组、联合1组、联合2组,每组各30例.单用组采用铂类化疗方案治疗(多西他赛联合顺铂),联合1组在单用组基础上加用复方苦参注射液,联合2组在联合1组基础上加用特瑞普利单抗治疗.对比3组患者的近期疗效,治疗前、治疗后6个月的免疫功能指标(CD4+、CD8+、CD4+/CD8+)、前列腺症状评分、最大尿流率、前列腺体积、生存质量评分,治疗过程中不良反应发生情况,分析3组前列腺癌患者的生存结果.结果 3组的总缓解率比较,差异无统计学意义(P＞0.05).治疗后6个月,单用组CD4+、CD4+/CD8+较治疗前降低,CD8+较治疗前升高,联合2组CD4+、CD4+/CD8+较治疗前升高,CD8+较治疗前降低,差异均有统计学意义(P＜0.05),而联合1组治疗前后免疫功能无明显变化,差异均无统计学意义(P＞0.05);3组间比较:联合2组、联合1组治疗后6个月的CD4+、CD4+/CD8+高于单用组,CD8+低于单用组,且联合2组CD4+、CD4+/CD8+高于联合1组,CD8+低于联合1组,差异均有统计学意义(P＜0.05).治疗后6个月,3组的前列腺症状评分、前列腺体积较治疗前明显降低,最大尿流率较治疗前明显升高,差异均有统计学意义(P＜0.05);3组间比较:联合1组、联合2组治疗后6个月的前列腺症状评分、前列腺体积均低于单用组,最大尿流率高于单用组,且联合2组的前列腺症状评分、前列腺体积均低于联合1组,最大尿流率高于联合1组,差异均有统计学意义(P＜0.05).治疗后6个月,3组各生存质量评分均较治疗前降低,差异均统计学意义(P＜0.05);3组间比较:联合1组、联合2组治疗后6个月的各生存质量评分均低于单用组,联合2组各生存质量评分低于联合1组,差异均有统计学意义(P＜0.05).联合2组的不良反应发生率均低于单用组和联合1组,差异均有统计学意义(P＜0.05). 3组的总生存率及生存时间比较,差异均无统计学意义(P＞0.05).结论 复方苦参注射液联合特瑞普利单抗及铂类化疗方案可明显改善中晚期前列腺癌患者的免疫功能,降低不良反应发生率,提高生存质量,具有较好的应用效果.
Abstract
Objective To investigate the effects and immune function of compound matrine injection combined with toripalimab and plati-num-based chemotherapy in patients with advanced prostate cancer.Methods A total of 90 patients with advanced prostate cancer diagnosed and treated in Shangluo Central Hospital from March 2019 to March 2021 were prospectively selected as the study subjects.According to the ran-dom number table method,the patients were divided into single group,combined group 1 and combined group 2,with 30 cases in each group.The single group was treated with platinum-based chemotherapy regimen(docetaxel combined with cisplatin),combined with group 1 on the basis of compound Sophora sophora injection,combined with 2 groups treated with toripalimab on the basis of combination group 1.The survival results of prostate cancer patients in the three groups were analyzed by comparing the short-term efficacy,immune function indexes(CD4+,CD8+,CD4+/CD8+),prostate symptom scores,maximum urinary flow rate,prostate volume,quality of life scores,and adverse reactions during treat-ment before treatment and 6 months after treatment.Results There was no significant difference in the total remission rate among the three groups(P＞0.05).Six months after treatment,CD4+and CD4+/CD8+in the single group were lower than those before treatment,CD8+was higher than that before treatment,CD4+and CD4+/CD8+in the combined group were higher than those before treatment,CD8+was lower than that be-fore treatment,and the differences were statistically significant(P＜0.05);there was no significant change in immune function before and after treatment in the combined group 1,and the difference was not statistically significant(P＞0.05).Comparison among the three groups:CD4+and CD4+/CD8+in the combined group 2 and the combined group 1 were higher than those in the single group at 6 months after treatment,and CD8+was lower than that in the single group,and CD4+and CD4+/CD8+in the combined group 2 were higher than those in the combined group 1,and CD8+was lower than that in the combined group 1,the differences were statistically significant(P＜0.05).At 6 months after treatment,the prostate symptom score and prostate volume in the three groups were significantly lower than those before treatment,and the maxi-mum urinary flow rate was significantly higher than that before treatment,differences being significant(P＜0.05).Comparison among the three groups:the prostate symptom score and prostate volume of the combined group 1 and the combined group 2 were lower than those of the single group at 6 months after treatment,and the maximum urinary flow rate was higher than that of the single group,the prostate symptom score and prostate volume of the combined group 2 were lower than those of the combined group 1,and the maximum urinary flow rate was higher than that of the combined group 1,the differences were statistically significant(P＜0.05).At 6 months after treatment,the quality of life scores of the three groups were lower than those before treatment,and the differences were statistically significant(P＜0.05).Comparison among the three groups:the quality of life scores of the combined group 1 and the combined group 2 were lower than those of the single group at 6 months after treatment,and the quality of life scores of the combined group 2 were lower than those of the combined group 1,the differences were statistically significant(P＜0.05).The incidence of adverse reactions in the combined group 2 was lower than that in the single group and the combined group 1,the differences were statistically significant(P＜0.05).There was no significant difference in the overall survival rate and survival time among the three groups(P＞0.05).Conclusion Compound matrine injection combined with toripalimab and platinum-based chemotherapy can significantly improve the immune function,reduce the incidence of adverse reactions,and improve the life quality with advanced prostate canc-er,and have a good application effect.
关键词
复方苦参注射液/特瑞普利单抗/铂类化疗方案/前列腺肿瘤/免疫功能Key words
Compound matrine injection/Toripalimab/Platinum-based chemotherapy regimen/Prostatic neoplasms/Immune function引用本文复制引用
出版年
2024
NETL
NSTL
万方数据