复方苦参注射液联合调强放疗及腔内后装治疗宫颈癌疗效观察

摘要

Objective It is to observe the recent curative effect and occurrence of side effect of compound sophora flaves-cens ait injection combined with intensity modulated radiation therapy( IMRT)and 192 Ir intracavitary brachy therapy in the treatment for cervical carcinoma. Methods Seventy cervical cancer patients were divided randomly into two groups,the control group(35cases)and the observation group(35cases). Both groups received IMRT plus intracavitary brachytherapy(1. 8 -2. 2 Gy per fraction,5 fractions per week,with an average dose of 54. 5 Gy),Intracavitary brach therapy was to a total dose of 24 - 30 Gy at 6 Gy per fraction once a week after the dose of IMRT reached 30 Gy. Besides,the observation group received 20 mL of compound sophora flavescens ait injection once a day for 21 days. The recent curative effect,occurrence of side effect, the changes of KPS,CD3 + ,CD4 + ,CD8 + ,CD56 + ,IL - 6 were observed in both groups. Results There was no difference in recent curative effect between the two group(P > 0. 05). KPS was significantly increased and in both groups after treatment, and the increase in observation group was more significant than that in control group after treatment(P < 0. 05). After treat-ment,the levels of CD3 + ,CD4 + and IL - 6 was obviously increased in observation group( P < 0. 05),while in control group,the level of CD3 + ,CD4 + was obviously decreased and IL - 6 was increased after treatment( P < 0. 05);After treat-ment,the levels of CD3 + ,CD4 + ,CD8 + and CD56 + in observation group were higher and IL - 6 was lower than those in con-trol group(P < 0. 05);The acute radiation enteritis and hematology toxic in observation group were obviously lower than those in control groups(P < 0. 05). Conclusion Compound sophora flavescens ait injection could enhance the sensitivity of cervix car-cinoma cells to IMRT and intracavitary brach therapy through protecting the cell immunologic function and decreasing side effect.%目的：观察复方苦参注射液配合调强放疗及192 Ir 腔内后装治疗宫颈癌的近期疗效及毒副反应发生情况。方法将70例宫颈癌患者随机分为2组，对照组35例给予6 MV X 射线调强放疗，1.8～2.2 Gy /次，每周5次，放疗30 Gy 后开始进行腔内后装治疗，后装照射共5次，每周1次，每次6 Gy，治疗当日不进行外照射。研究组35例在对照组治疗基础上给予复方苦参注射液20 mL 加入250 mL 生理盐水中静脉滴注，每天1次，连续使用21 d。观察2组近期疗效及毒副反应发生情况，治疗前后 KPS 评分及 CD3＋、CD4＋、CD8＋、CD56＋、白细胞介素-6（IL -6）变化情况。结果2组近期有效率比较差异无统计学意义（P ＞0.05）。对照组治疗后 KPS 评分较治疗前明显降低（P ＜0.05），而研究组 KPS 评分明显高于治疗前及对照组（P 均＜0.05）。研究组治疗后 CD3＋、CD4＋、IL -6水平均较治疗前明显升高（P 均＜0.05）；对照组 CD3＋、CD8＋水平较治疗前下降（P 均＜0.05），IL -6水 平 较 治 疗 前 明 显 升 高（ P ＜0.05）；研究组治疗后 CD3＋、CD4＋、CD8＋和CD56＋水平均明显高于对照组（P 均＜0.05），IL -6水平明显低于对照组（P ＜0.05）。研究组急性放射性肠炎及血液学毒性的程度均明显低于对照组（P 均＜0.05）。结论复方苦参注射液可通过直接杀伤肿瘤细胞及保护机体免疫功能等途径增强调强放疗和腔内后装治疗宫颈癌的疗效，并可有效减少放疗毒副反应的发生。