| 郑 超,陈 超,赵 磊,高浚臣,吴 晨.三维适形放疗联合GT化疗方案对晚期膀胱癌患者免疫功能、生活质量及肿瘤标志物水平的影响[J].,2022,(1):88-93 |
| 三维适形放疗联合GT化疗方案对晚期膀胱癌患者免疫功能、生活质量及肿瘤标志物水平的影响 |
| Effects of three-dimensional Conformal Radiotherapy Combined with GT Chemotherapy regimen on Immune Function, Quality of Life and Tumor Markers in Patients with Advanced Bladder Cancer |
| 投稿时间：2021-05-30 修订日期：2021-06-25 |
| DOI：10.13241/j.cnki.pmb.2022.01.015 |
| 中文关键词: 三维适形放疗 GT化疗 晚期膀胱癌 免疫功能 生活质量 肿瘤标志物 |
| 英文关键词: Three dimensional conformal radiotherapy GT chemotherapy Advanced bladder cancer Immune function Quality of life Tumor markers |
| 基金项目:北京市自然科学基金项目（7162056） |
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| 中文摘要: |
| 摘要 目的：探讨三维适形放疗联合吉西他滨及多西他赛（GT）化疗方案对晚期膀胱癌患者免疫功能、生活质量及肿瘤标志物水平的影响。方法：选取2015年3月~ 2018年8月期间我院收治的晚期膀胱癌患者98例，采用随机数字表法将患者分为两组，其中对照组49例患者，接受GT化疗，观察组49例患者，三维适形放疗联合GT化疗，均以4周为1个疗程，治疗4个疗程。观察两组治疗4个疗程后的疗效以及不良反应发生情况，对比两组治疗前、治疗4个疗程后的免疫功能、生活质量及肿瘤标志物水平，随访2年，观察两组患者生存率。结果：观察组的临床总有效率为53.06%（26/49），高于对照组的30.61%（15/49），差异有统计学意义（P<0.05）。两组不良反应发生率组间对比差异无统计学意义（P>0.05）。治疗4个疗程后，与对照组相比，观察组的CD8+更低，CD3+、CD4+、CD4+/CD8+更高（P<0.05）。治疗4个疗程后，与对照组相比，观察组的膀胱肿瘤抗原（BTA）、核基质蛋白22（NMP22）、尿膀胱癌抗原（UBC）更低，差异有统计学意义（P<0.05）。治疗4个疗程后，与对照组相比，观察组的物质功能、心理功能、社会功能、躯体功能各维度评分及总分更高（P<0.05）。观察组的生存率高于对照组（P<0.05）。结论：三维适形放疗联合GT化疗可有效阻止晚期膀胱癌患者疾病进展，减轻免疫抑制，同时治疗期间不会增加不良反应发生率，可促进患者生活质量改善，疗效可靠。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of three-dimensional conformal radiotherapy combined with gemcitabine combined with docetaxel (GT) chemotherapy regimen on immune function, quality of life and tumor markers in patients with advanced bladder cancer. Methods: 98 patients with advanced bladder cancer in our hospital from March 2015 to August 2018 were selected, and they were divided into the control group and the observation group by randomly number table, with 49 cases in each group. The control group was treated with GT chemotherapy regimen, while the observation group was treated with three-dimensional conformal radiotherapy on the basis of the control group, with 4 weeks as a course of treatment, and 4 courses of treatment. The curative effect and adverse reactions of the two groups at 4 courses after treatment were observed. The immune function, quality of life and tumor markers levels of the two groups before and 4 courses after treatment were compared. The survival rate of the two groups were observed after 2 years of follow-up. Results: The total effective rate of the observation group was 53.06% (26/49), which was higher than 30.61% (15/49) of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 4 courses after treatment, compared with the control group, the CD3+, CD4+, CD4+/ CD8+ of the observation group were higher, and the CD8+ was lower(P<0.05). 4 courses after treatment, compared with the control group, the bladder tumor antigen (BTA), nuclear matrix protein 22 (NMP22), urinary bladder cancer antigen (UBC) of the observation group were lower (P<0.05). 4 courses after treatment, compared with the control group, the scores of psychological function, social function, material function, physical function each dimension and total score of the observation group were higher (P<0.05). The survival rate of the observation group were higher than those of the control group (P<0.05). Conclusion: Three dimensional conformal radiotherapy combined with GT chemotherapy can effectively prevent progression of disease and reduce immunosuppression in patients with advanced bladder cancer. At the same time, the incidence of adverse reactions will not increase during the treatment period, and the quality of life of patients will be improved and the curative effect will be reliable. |
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