黄芪注射液治疗子宫内膜癌的生活质量、免疫功能和治疗结果：一项回顾性队列研究

Adjuvant chemotherapy with paclitaxel and carboplatin is commonly used for high-risk postoperative endometrial cancer but is associated with significant toxicity. Astragalus Injection has immunomodulatory properties, yet clinical evidence regarding its adjunctive role remains limited. This retrospective cohort study compared quality of life, immune parameters, exploratory serum biomarkers, performance status, and adverse events between patients receiving paclitaxel-carboplatin with or without adjunctive Astragalus Injection. A total of 136 patients treated between January 2022 and March 2023 were included in an observation group (chemotherapy plus Astragalus Injection, n = 68) or control group (chemotherapy alone, n = 68). Treatment consisted of six 21-day cycles. Outcomes included European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) scores, CD4⁺ and CD8⁺ T-cell counts, CD4⁺/CD8⁺ ratio, squamous cell carcinoma antigen (SCC-Ag), cytokeratin 19 fragment (CYFRA21-1), adverse events, and Karnofsky Performance Status (KPS) scores. Changes in all five EORTC QLQ-C30 functional domain scores were significantly greater in the observation group than in the control group (P < 0.001). The increase in CD4⁺/CD8⁺ ratio was also significantly greater in the observation group (P < 0.001). SCC-Ag and CYFRA21-1 decreased more substantially in the observation group (P = 0.003 and P < 0.001, respectively). The incidences of grade ≥ 2 gastrointestinal toxicity (14.71% vs. 32.35%, P = 0.015) and bone marrow suppression (11.76% vs. 27.94%, P = 0.019) were lower in the observation group. KPS improvement was greater in the observation group (P < 0.001). Adjunctive Astragalus Injection was associated with improvements in quality of life, immune parameters, performance status, selected chemotherapy-related adverse events, and exploratory serum biomarkers. These findings are hypothesis-generating and require confirmation in prospective studies.