不同化疗方案对晚期非小细胞肺癌患者骨髓抑制及免疫功能的影响

目的:探讨不同化疗方案对晚期非小细胞肺癌患者骨髓抑制及免疫功能的影响。方法:选取2011年1月至2013年12月收治的130例晚期非小细胞肺癌患者,按照知情同意原则随机分为三组:NP(长春瑞滨+顺铂)组45例、GP(吉西他滨+顺铂)组43例、TP(紫杉醇+顺铂)组42例,分别于化疗前及化疗2个周期后检测患者的骨髓抑制及免疫水平。结果:三种化疗方案进行治疗后骨髓抑制水平由高到低排列为GP组、TP组、NP组,差异有统计学意义(P0.05);GP组血小板减少发生率高于其他两组,TP组白细胞下降发生率高于其他两组,差异有统计学意义(P0.05);三组患者化疗后的免疫功能指标均较化疗前低,差异有统计学意义(P0.05)。三种化疗方案进行治疗后免疫功能抑制水平由高到低排列为GP组、TP组、NP组,差异有统计学意义(P0.05)。结论:GP组患者血小板下降更明显,TP组白细胞下降更为明显,NP组对骨髓抑制及免疫功能抑制较缓和,更适于老年人,因此临床选择化疗方案时要综合考虑患者骨髓状况、免疫功能情况及年龄等。

Effect on Bone Marrow Suppression and Immune Function of Different Chemotherapy Regimens in Patients with Advanced non Small Cell Lung Cancer

Objective:To study the effect on bone marrow suppression and immune function of different chemotherapy regimens in advanced non small cell lung cancer patient.Methods:130 cases of advanced non small cell lung cancer patients treated in our hospital from January 2011 to December 2013 were selected and randomly divided into 3 groups according to the principle of informed consent: NP group(Changchun vinorelbine plus DDP, n=45), GP group(Gemcitabine plus DDP, n=43)and TP group(Docetaxel plus DDP, n=42). Bone marrow suppression and immune level were detected before the chemotherapy and after 2 cycles of the chemotherapy respectively.Results:The after-treatment bone marrow suppression levels of the three chemotherapy regimens ranked from high to low as GP group, TP group and NP group, and the difference was statistically significant (P<0.05). The thrombocytopenia rate of GP group was higher than the other two groups, the leucopenia rate of TP group was higher than the other two groups, the difference was statistically significant (P<0.05). The immune function indicators of three groups after treatment were decreased than those before the treatment, the difference was statistically significant (P<0.05). The immune function suppression levels of the three kinds of chemotherapy regimens after treatment ranked GP group, TP group and NP group fromhigh to lowin order,the difference was statistically significant (P<0.05).Conclusion:The thrombocytopenia is more significant in group GP, the leucopenia is more significant in group TP, the effect on bone marrow suppression and immune function of group NP is more moderate and suitable for the elderly. Therefore, the bone marrow status, immune function and age of patients should be taken into consideration when clinical chemotherapy regimens are chosen .