不同剂量培美曲塞联合大分割放疗对ⅢA-B期非小细胞肺癌血清VEGF、TK1水平的影响  

Effect of different doses pemetrexed combined with hypofractionated high-dose radiotherapy on serum VEGF and TK1 levels in patients with stage ⅢA-B non-small cell lung cancer

作　　者：张午临 杨庚武[2] 任淑敏 ZHANG Wu-lin;YANG Geng-wu;REN Shu-min(Thoracic Surgery Department,Central Hospital of Handan,Handan,Hebei 056000,China)

机构地区：[1]邯郸市中心医院胸外科,河北邯郸056000 [2]邯郸市中心医院放疗科,河北邯郸056000 [3]邯郸市第七医院手术室,河北邯郸056000

出　　处：《临床肺科杂志》2018年第10期1866-1870,共5页Journal of Clinical Pulmonary Medicine

基　　金：邯郸市科学技术研究与发展计划项目(No 1423108108)

摘　　要：目的探究不同剂量培美曲塞联合大分割放疗对ⅢA-B期非小细胞肺癌的血清血管内皮生长因子(Vascular endothelial growth factor,VEGF)和细胞质胸苷激酶1(Thymidine kinase,TKl)水平的影响。方法选择2014年1月至2016年12月我院收治的200例ⅢA-B期非小细胞肺癌患者,随机数表法将患者分为高剂量组和低剂量组,每组100例;其中高剂量组给予500 mg/m^2培美曲塞行化疗联合大分割放疗,低剂量组给予200 mg/m^2培美曲塞行化疗联合大分割放疗。比较两组患者的临床疗效、治疗前后血清VEGF和TK1水平以及不良反应。结果高剂量组患者的总有效率显著高于低剂量组(38.00%vs 25.00%),差异具有统计学意义(P<0.05)。与治疗前相比,高剂量组[(976±95)vs(556±103)pg/m L]和低剂量组[(982±87)vs(768±117)pg/m L]患者治疗后的VEGF水平均显著下降,且高剂量组显著低于低剂量组(556±103)vs(768±117)pg/m L,差异具有统计学意义(P<0.05);高剂量组[(0.97±0.15)vs(1.44±0.11)p M]和低剂量[(1.12±0.10)vs(1.46±0.17)p M]的血清TK1水平分别较治疗前显著降低,且高剂量组显著低于低剂量组[(0.97±0.15)vs(1.12±0.10)p M],差异具有统计学意义(P<0.05)。高剂量组不良反应发生率显著高于低剂量,差异具有统计学意义(P<0.05)。结论高剂量培美曲塞联合大分割放疗对ⅢA-B期非小细胞肺癌的疗效显著,但不良反应增加,其可能通过调节患者血清VEGF和TK1水平,抑制肺癌的转移和侵袭。值得进一步研究。Objective To explore the levels of serum VEGF and TK1 in patients with stage ⅢA-B non-small cell lung cancer who were treated with hypofractionated high-dose radiotherapy combined with different doses pemetrexed.Methods 200 patients with stage ⅢA-B non-small cell lung cancer were selected from Jan.2014 to Dec.2016 in our hospital,and then they were randomly divided into the high does group and the low does group.The high does group was given pemetrexed with 500 mg/m^2 combined with hypofractionated high-dose radiotherapy,and the low does group was given pemetrexed with 200 mg/m^2 combined with hypofractionated high-dose radiotherapy.The clinical efficacy,serum VEGF and TK1 levels at pre-treatment and post-treatment,and the adverse reactions were detected in the two groups.Results In the high does group,the total clinical efficacy was significantly higher than that in the low does group（38.00% vs 25.00%）（ P〈0.05）.After treatment,the serum VEGF levels of the high dose group [（556 ± 103） vs（976 ± 95）]and the low dose groups [（768 ± 117） vs（982 ± 87）]pg/m L were significantly lower than those before treatment,and the high does group was significantly lower than the low does group [（556± 103） vs（768 ± 117）] pg/m L（ P〈0.05）.And the serum TK1 levels of the high dose group [（0.97 ± 0.15） vs（1.44 ± 0.11）]and the low dose groups [（1.12 ± 0.10） vs（1.46 ± 0.17）]p M were significantly lower than those before treatment,and the high does group was significantly lower than the low does group [（0.97 ± 0.15） vs（1.12± 0.10）] p M（ P〈0.05）.The incidence of adverse reactions in the high does group was significantly higher than that in the low does group（ P〈0.05）.Conclusion High-dose pemetrexed combined with hypofractionated highdose radiotherapy has a significant clinical efficacy in treatmrnt of stage ⅢA-B non-small cell lung cancer,and pemetrexed can inhibit the metastasis and invasion of lung cancer by the regulation of serum VEGF and TK1

关 键 词：培美曲塞 大分割放疗 非小细胞肺癌 血管内皮生长因子 细胞质胸苷激酶1 

分 类 号：R734.2[医药卫生—肿瘤]