紫杉醇联合卡铂化疗同期调强适形放疗对老年晚期宫颈癌患者疗效观察及对患者生活质量和免疫功能影响

intensity-modulated radiotherapy in the treatment of elderly patients with advanced cervical cancer and its impact on the quality of life and immune function

摘要:

目的：探讨紫杉醇联合卡铂化疗同期调强适形放疗对老年晚期宫颈癌患者疗效观察及对患者生活质量和免疫功能影响。方法：选取2012年1月至2014年1月我院肿瘤科收治的老年晚期宫颈癌患者98例，按照随机表法分为观察组（n=49）与对照组（n=49）。观察组采用紫杉醇联合卡铂化疗同期调强适形放疗，对照组仅采用调强适形放疗。2组连续化疗3周为1疗程，连续治疗3~4个疗程。比较2组治疗疗效、治疗前后生活质量评分、免疫功能指标变化，随访1年、2年和3年生存情况，及局部复发情况和远处转移情况。结果：观察组总有效率（75.51%）高于对照组（46.94%）（χ2=8.425，P=0.000）。2组治疗后认知功能、社会功能、情绪功能、自觉功能及躯体功能评分增加（观察组：t=35.110、23.405、18.263、20.795、17.879，对照组：t=23.838、13.479、7.298、13.627、8.138，均P<0.05）；观察组治疗后认知功能、社会功能、情绪功能、自觉功能及躯体功能评分高于对照组（t=9.921、9.038、11.774、8.965、9.757，均P<0.05）。2组治疗后CD3+、CD4+及CD4+/CD8+降低（观察组：t=7.542、7.747、10.243，对照组：t=16.560、12.871、14.326，均P<0.05）；观察组治疗后CD3+、CD4+及CD4+/CD8+高于对照组（t=11.082、7.293、7.653，均P<0.05）。观察组随访2年生存率和3年生存率高于对照组，且局部复发率和远处转移率低于对照组（χ2=4.602、5.289、6.078，均P<0.05）。结论：紫杉醇联合卡铂化疗同期调强适形放疗对老年晚期宫颈癌患者近期和远期疗效明显，可改善患者生活质量，对患者免疫功能影响小，具有重要研究价值。

Abstract:

Objective：To investigate the efficacy of paclitaxel combined with carboplatin chemotherapy and intensity-modulated radio－therapy（IMRT） in the treatment of elderly patients with advanced cervical cancer and its influence on the quality of life and immune function. Methods：A total of 98 elderly patients with advanced cervical cancer admitted to the department of oncology between January 2012 to January 2014 were selected and randomly divided into the observation group（49 cases） and the control group（49 cases）. The observation group received paclitaxel combined with carboplatin chemotherapy and IMRT，while the control group only received IMRT. Continuous chemotherapy for 3 weeks was taken as one course，and the patients in the two groups underwent continuous 3 to 4 coursed of treatment. The therapeutic efficacy，quality of life score and immune function changes before and after treatment were com－pared between the two groups，followed up for 1 year，2 years and 3 years，and the local recurrence and distant metastasis were recorded. Results：The total effective rate of the observation group（75.51%） was higher than that of the control group（46.94%） （χ2=8.425，P=0.000）. After the treatment，the scores of cognitive function，social function，emotional function，consciousness function and physical function were increased（observation group：t=35.110，23.405，18.263，20.795，17.879；control group：t=23.838，13.479，7.298，13.627，8.138，all P<0.05）；the scores were higher in the obser－vation group than in the control group（t=9.921，9.038，11.774，8.965，9.757，all P<0.05）. CD3+，CD4+ and CD4+/CD8+ were decreased in two groups after the treatment（observation group：t=7.542，7.747，10.243；the control group：t=16.560，12.871，14.326，all P<0.05）. After the treatment，CD3+，CD4+ and CD4+/CD8+ were higher in the observation groupthan in the control group（t=11.082，7.293，7.653，all P<0.05）. The 2 year survival rate and 3 year survival rate of the observation group were higher than those of the control group，and the local recurrence rate and distant metastasis rate of the observation group were lower than those of the control group（χ2=4.602，5.289，6.078，all P<0.05）. Conclusion：Paclitaxel and carboplatin chemotherapy combined with IMRT have signifi－cant short-term and long-term efficacy for elderly patients with advanced cervical cancer，and can improve the quality of life of pa－tients，with little side effect in the immune function，therefore it has important research value.