华蟾素联合 GP方案治疗中晚期非小细胞肺癌的临床疗效和抗肿瘤机理

摘要

Objective To explore the clinical efficacy and anti-tumor mechanism of cinobufacini combined with GP regi-men for advanced non-small cell lung cancer( NSCLC) .Methods 90 patients with advanced NSCLC were divided randomly into the control group and the observation group.The control group were treated with GP regimen.Patients in the observation group were treated with cinobufacini combined GP regimen.The regime repeated in 28 days.All patients were treated for 56 days.The immune function,treatment efficiency,mean survival time,1-,2-year survival rate and side effects of the 2 group were analyzed. Results Compared with before the treatment,the immune function in the control group after treatment did not significantly im-prove (P>0.05).The percentage of CD4 T lymphocytes and NK cells and the ratio of CD4 and CD8 T lymphocytes in the obser-vation group after treatment significantly enhanced than that before treatment (P<0.05).The treatment efficiency in the observa-tion group significantly increased than that of the control group (P<0.05).Mean survival time and 1-,2-year survival rate in the observation group significantly enhanced than that of the control group (P<0.05).The side effects had no statistical difference between the 2 groups (P>0.05).Conclusion Cinobufotalin not only inhibit tumor cells,promote tumor cell apoptosis,but aslo improve immune function in patients with advanced NSCLC.Cinobufacini combined with GP regimen have better clinical efficacy, and it is worthy of clinical application.%目的：探讨华蟾素联合GP化疗方案治疗中晚期非小细胞肺癌的临床效果和抗肿瘤机制。方法将接受治疗的中晚期非小细胞肺癌患者随机分为对照组和观察组，对照组采用GP化疗方案进行治疗（吉西他滨1000 mg／m2， d1、d8；顺铂80～100 mg／m2，d2～3）；观察组患者在对照组治疗的基础上给予静脉注射华蟾素20 ml／d，d1～10。28天为1个疗程。2个疗程后分别对2组患者免疫功能，治疗有效率，中位生存时间，1、2年生存率和不良反应进行对比分析。结果对照组治疗前后CD4和CD8 T淋巴细胞、NK细胞比例及CD4／CD8比值比较无差异（P＞0．05）。观察组治疗后CD4 T淋巴细胞比例，NK细胞比例和CD4／CD8比值较治疗前显著增加，而CD8 T淋巴细胞比例较治疗前显著下降，差异均有统计学意义（P＜0．05）。观察组临床治疗有效率（62．22％）较对照组（40．00％）明显提高，差异有统计学意义（P＜0．05）。观察组中位生存时间明显长于对照组（P＜0．05）。观察组1、2年生存率明显高于对照组，差异有统计学意义（P＜0．05）。对照组和观察组患者主要不良反应发生率比较，差异无统计学意义（P＞0．05）。结论华蟾素不仅可抑制肿瘤细胞增加，促进肿瘤细胞凋亡，而且可提高患者免疫功能，这一机理可能是其与GP方案连用治疗中晚期非小细胞肺癌效果优于单纯GP方案的原因之一。因此华蟾素联合GP方案治疗中晚期非小细胞肺癌值得临床推广使用。