多西他赛联合卡铂对口腔癌患者免疫功能、炎症反应及生活质量的影响

Effects of docetaxel combined with carboplatin on immune function, inflammatory response, and quality of life in patients with oral cancer

摘要:

目的 探讨多西他赛联合卡铂对口腔癌患者免疫功能、炎症反应及生活质量的影响。方法 选取2022年1月—2024年1月在北京中医药大学东方医院秦皇岛医院接受治疗的口腔癌患者102例，采用随机数字表法分为对照组、观察组，各51例。对照组接受紫杉醇与顺铂化疗，观察组采用多西他赛联合卡铂。21 d为1个疗程，两组均治疗3个疗程。比较两组患者的临床疗效，治疗前后的免疫功能（CD3^＋、CD4^＋、CD8^＋）、炎症因子水平［白细胞介素-6（IL-6）、C-反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）］、肿瘤标志物水平，评估患者治疗前后的生活质量，并记录不良反应发生情况。治疗后随访2年，记录总生存期（OS）和生存率。结果 观察组客观缓解率高于对照组（P <0.05）。观察组治疗后CD3^＋和CD4^＋水平均高于对照组，CD8^＋水平低于对照组（P <0.05）；两组治疗后CD3^＋、CD4^＋水平均低于治疗前，CD8^＋水平高于治疗前（P <0.05）。观察组治疗后IL-6、TNF-α、CRP水平低于对照组（P <0.05），两组治疗后IL-6、TNF-α、CRP水平均低于治疗前（P <0.05）。观察组治疗后癌胚抗原（CEA）、糖类抗原19-9（CA19-9）、鳞状上皮细胞癌抗原（SCCAg）水平低于对照组（P <0.05），两组治疗后CEA、CA19-9、SCCAg水平均低于治疗前（P <0.05）。观察组治疗后口腔健康影响程度量表（OHIP）、华盛顿大学生存质量问卷（UW-QOL）评分均高于对照组（P <0.05），两组治疗后OHIP、UW-QOL评分均高于治疗前（P <0.05）。对照组与观察组不良反应总发生率比较，差异无统计学意义（P >0.05）。随访2年结果显示，观察组和对照组OS分别为21.55（20.17，22.93）、18.45（16.47，20.43），观察组各时点总生存率高于对照组（P <0.05）。结论 多西他赛联合卡铂可改善口腔癌患者免疫功能，减轻炎症，进而提高生活质量和生存率。

Abstract:

Objective To investigate the effects of docetaxel combined with carboplatin on immune function, inflammatory response, and quality of life in patients with oral cancer.Methods A total of 102 patients with oral cancer treated at Qinhuangdao Hospital of Beijing University of Chinese Medicine between January 2022 and January 2024 were randomly divided into a control group and an observation group using a random number table, with 51 patients in each group. The control group received paclitaxel plus cisplatin, whereas the observation group received docetaxel plus carboplatin. Each cycle lasted 21 days, and both groups received three cycles. Clinical efficacy; immune function (CD3⁺, CD4⁺, and CD8⁺); inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-alpha)]; tumor markers; quality of life; and adverse reactions were compared between the groups. Patients were followed for 2 years after treatment, and overall survival (OS) and survival rates were recorded.Results The objective response rate was higher in the observation group than in the control group (P < 0.05). After treatment, CD3⁺ and CD4⁺ levels were higher and CD8⁺ levels were lower in the observation group than in the control group (P < 0.05); in both groups, CD3⁺ and CD4⁺ levels were lower and CD8⁺ levels were higher after treatment than before treatment (P < 0.05). Post-treatment IL-6, TNF-alpha, and CRP levels were lower in the observation group than in the control group, and all three levels were lower after treatment than before treatment in both groups (P < 0.05). Post-treatment carcinoembryonic antigen, carbohydrate antigen 19-9, and squamous cell carcinoma antigen levels were lower in the observation group than in the control group, and all three levels were lower after treatment than before treatment in both groups (P < 0.05). Post-treatment Oral Health Impact Profile and University of Washington Quality of Life scores were higher in the observation group than in the control group and were higher after treatment than before treatment in both groups (P < 0.05). The overall incidence of adverse reactions did not differ significantly between the groups (P > 0.05). At the 2-year follow-up, OS was 21.55 (20.17, 22.93) months in the observation group and 18.45 (16.47, 20.43) months in the control group, and the overall survival rate at each time point was higher in the observation group than in the control group (P < 0.05).Conclusion Docetaxel combined with carboplatin improves immune function, reduces inflammation, and enhances quality of life and survival in patients with oral cancer.