| Objective:The establishment of Elemene combined with Docetaxel and Oxaliplatin in the observation group and the combination of Docetaxel and Oxaliplatin control group for neoadjuvant chemotherapy,To evaluate the curative effect of the patients with locally advanced esophageal cancer after the treatment of 2 cycles,observe the changes of the KPS score,the side effects of chemotherapy and the effects on the immune T cells and NK cells in the two groups at the same time to provide a possible optimization strategy for neoadjuvant chemotherapy for esophageal cancer surgery.Methods:Selection of esophageal squamous cell carcinoma patients in our hospital from February 2017 to January 2018,exclusion of patients with stage I,II A,IV and surgical contraindications,44 cases of locally advanced esophageal squamous cell carcinoma were randomly divided into the control group and the observation group by the envelope method,and received neoadjuvant chemotherapy.21 cases in the observation group were treated with Elemene Oral Emulusion combined DTX/OXA,23 cases in the control group were given DTX/OXA alone,21 day was a 1 cycle,all of which were evaluated after 2 cycles of treatment.The change of tumor size and weight change,examination of blood routine,liver and kidney function,immune function,the change of quality of life,clinical symptoms and Chemotherapeutic side reaction were recorded respectively after treatment.Results:1.The change of tumor size.The ORR(CR+PR)was 58.3%(10/21)and the DCR(CR+PR+SD)was 90.4%(18/21)in the observation group after treatment.The ORR(CR+PR)of the control group was 40.9%(6/22),and the DCR(CR+PR+SD)was 86.3%(17/22)after treatment.The results showed that the efficiency and stability of the observation group were higher than those of the control group,but there was no statistically significant difference between the two groups of ORR and DCR(P>0.05).2.Improvement of clinical symptoms.Through KPS score assessment,the quality of life in the observation group was increased in 13 cases,stable in 5 cases,and decreased in 3 cases.In the control group,the quality of life increased in 5 cases,stable in 9 cases,and decreased in 8 cases.The results of statistical test showed that P<0.05 was statistically significant in the two groups,the quality of life in the observation group of the two groups was significantly higher than that before the treatment,P<0.05,with statistical significance.The quality of life in the control group was lower than that before treatment,and the quality of life assessment and were not statistically significant(P>0.05).3.Body weight change.The two groups were compared between groups,the weight gain in the observation group was 12 cases,stable in 6 cases,and decreased in 3 cases after treatment,the control group increased 5 cases,stabilized 8 cases,and decreased 9 cases.After statistical examination,(P<0.05)showed statistical significance.4.In the occurrence of toxic and side effects.The two groups of patients had different degrees of bone marrow depression,digestive tract reaction and liver and kidney function injury after chemotherapy,the number of cases in the observation group was less than that in the control group,and the side effects were mild.Especially in the 5 items of WBC reduction,PLT reduction,ALT elevation,nausea and vomiting and diarrhea,P<0.05 was statistically significant.The decrease of hemoglobin and the increase of bilirubin,ALP,AST,Cr and BUN in the observation group were also more effective than those in the control group,but there was no statistical significance(P>0.05).5.In terms of enhancing body immunity,rank sum test showed that the level of NK and CD4+/CD8+ in the observation group was significantly higher than that in the control group after treatment(P<0.05).Conclusion:1.Elemene combined with Docetaxel and Oxaliplatin can increase the weight of the patients,enhance the immunity,improve the quality of life and enhance the tolerance of patients to operation compared with the control group..2.After 2 cycles of treatment,Elemene combined with Docetaxel and Oxaliplatin regimen is more effective than docetaxel plus oxaliplatin alone in the treatment of locally advanced esophageal squamous cell carcinoma,But there was no statistical difference between the two groups.3.Toxicity of Docetaxel and Oxaliplatin for advanced esophageal cancer treated with neoadjuvant chemotherapy in bone marrow suppression,gastrointestinal toxicity,abnormal liver function.Elemene combined with Docetaxel and Oxaliplatin compared to the control group can significantly reduce the toxicity of chemotherapy and increase the tolerance to chemotherapy of patients,especially in local advanced and elderly patients. |
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