摘要
目的比较调强放疗与立体定向体部放疗(SBRT)同步化疗对Ⅲ期非小细胞肺癌患者免疫功能及血清细胞因子的影响。方法根据不同的放疗方法将130例非小细胞肺癌患者分为观察组和对照组,各65例。两组患者化疗均采用吉西他滨联合顺铂方案,对照组患者放疗采用SBRT,观察组患者放疗采用调强放疗。比较两组患者疾病控制率(DCR)、治疗前后免疫功能指标(CD3^+、CD4^+、CD8^+T淋巴细胞及CD4^+/CD8^+)及血清细胞因子[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)及肿瘤坏死因子(TNF-ɑ)]水平。结果治疗后,观察组患者的DCR为73.8%(48/65),高于对照组患者的67.7%(44/65),但差异无统计学意义(P﹥0.05)。治疗后,两组患者的CD3^+、CD4^+T淋巴细胞及CD4^+/CD8^+比值较治疗前下降,CD8^+T淋巴细胞较治疗前上升;观察组患者的CD3^+、CD4^+T淋巴细胞及CD4^+/CD8^+比值高于对照组患者,CD8^+T淋巴细胞低于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后,两组患者的血清细胞因子较治疗前下降,且观察组患者的血清IL-2、IL-6及TNF-ɑ水平低于对照组患者,差异均有统计学意义(P﹤0.05)。结论在Ⅲ期非小细胞肺癌的治疗中,调强放疗与SBRT疗效相当,但调强放疗对免疫系统影响较小,有助于血清细胞因子水平的改善。
Objective To compare the effect of intensity modulated radiotherapy and stereotactic body radiotherapy (SBRT) on immune function and serum cytokines in patients with stage Ⅲ non-small cell lung cancer.Method All patients were divided into observation group and control group (65 cases in each) according to different treatments.Both groups were treated with gemcitabine combined with cisplatin (GP) regimen,with raidotherapy of SBRT in the control group and intensity-modulated radiotherapy in the observation group.The disease control rate (DCR),immune function indexes (CD3^+,CD4^+,CD8^+-T lymphocyte and CD4^+/CD8^+) and cytokines [interleukin-2 (IL-2),interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α)] before and after treatment were compared.Result DCR in the observation group 73.8%(48/65) was higher than that in the control group 67.7%(44/65) after treatment,with no significant difference (P> 0.05).The CD3^+,CD4^+T lymphocyte and CD4^+/CD8^+ratio decreased significantly in both groups after treatment,but the CD8^+T lymphocyte increased significantly.The CD3^+,CD4^+ T lymphocyte and CD4^+/CD8^+ ratio in the observation group were higher than those in the control group,CD8^+T lymphocyte lower than that in the control group,all with significant differences (P<0.05).After treatment,the level of cytokines was significantly lower than that before treatment;the levels of IL-2,IL-6 and TNF-α in the observation group were significantly lower than those in the control group,all with significant differences (P<0.05).Conclusion Intensity modulated radiotherapy has same effect as SBRT in the treatment of the stage Ⅲ non-small cell lung cancer,but intensity-modulated radiotherapy has less effect on the immune system, which is helpful for improvement of cytokines.
作者
王院霞
刘峰
郑巧平
朱丽萍
张晗
姚玉婷
WANG Yuanxia;LIU Feng;ZHENG Qiaoping;ZHU Liping;ZHANG Han;YAO Yuting(Department of Laboratory Medicine,the Ninth Affiliated Hospital to Medicial College of Shanghai Jiaotong University,Shanghai 200001,China;Department of Oncology,the Ninth Affiliated Hospital to Medicial College of Shanghai Jiaotong University,Shanghai 200001,China)
出处
《癌症进展》
2019年第19期2288-2291,共4页
Oncology Progress
关键词
非小细胞肺癌
调强放疗
立体定向体部放疗
non-small cell lung cancer
intensity modulated radiotherapy
stereotactic body radiotherapy
