血管内皮抑制素联合调强放疗对老年中晚期非小细胞肺癌的临床应用价值研究  

Exploration of the clinical value of endostatin combined with intensity-modulated radiotherapy in elderly patients with advanced non-small cell lung cancer

作　　者：杨娜[1] 孙毅[2] 迪丽努尔•尼加提 Yang Na;Sun Yi;Dilinuner·Nijiati(Department ofRadiotherapy,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi 830000,China;Cancer Center,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院放疗一科,乌鲁木齐830000 [2]新疆维吾尔自治区人民医院肿瘤中心,乌鲁木齐830000

出　　处：《中华细胞与干细胞杂志（电子版）》2021年第1期34-39,共6页Chinese Journal of Cell and Stem Cell（Electronic Edition）

基　　金：吴阶平医学基金会临床科研专项资助(320.6799.1143)。

摘　　要：目的探讨血管内皮抑制素联合调强放疗在老年中晚期非小细胞肺癌(NSCLC)中的放疗增敏作用及对T细胞、NK细胞的影响。方法选取2015年3月至2016年8月新疆维吾尔自治区人民医院NSCLC患者106例,依据简单随机数字表法分为对照组(采取调强放疗)与研究组(在对照组基础上使用血管内皮抑制素),每组53例。分析两组临床疗效、治疗前后NK细胞、T细胞水平、血清肿瘤标志物水平、EPO mRNA、EPO-R mRNA水平、毒副反应,随访3年后统计两组生存情况[中位总生存期(OS)、中位无进展生存期(PFS)]。两组比较采用独立样本t检验,组内治疗前后比较采用配对t检验,临床疗效、毒副反应发生率等采用c2检验。结果对照组肿瘤控制率低于研究组(69.81%比86.79%)(P<0.05);与治疗前比较,两组治疗后NK细胞、CD3±、CD4^+、CD4^+/CD8^+水平,血清CA199、CA125、CEA、CY211水平,EPO mRNA,EPO-R mRNA水平均降低,CD8^+水平增高,差异有统计学意义(P均<0.05);与对照组治疗后比较,研究组治疗后NK细胞[(8.01±1.64)%比(10.44±2.13)%]、CD3±[(53.51±6.02)%比(59.33±5.15)%],CD4^+[(32.31±4.01)%比(36.40±3.86)%]、CD4^+/CD8^+[(0.94±0.28)%比(1.23±0.30)%],中位PFS(5个月比8个月)、中位OS(18个月比23个月)升高,CD8^+[(34.22±3.08)%比(29.56±2.50)%],CA199[(35.20±4.46)kU/L比(30.15±4.14)kU/L]、CA125[(34.91±6.03)kU/L比(29.77±5.30)kU/L]、CEA[(22.50±3.97)μg/L比(17.97±4.10)μg/L]、CY211[(7.19±2.01)μg/L比(4.56±1.34)μg/L],EPO mRNA水平(0.85±0.08比0.80±0.06)、EPO-RmRNA水平(0.88±0.09比0.81±0.08)降低,差异具有统计学意义(P均<0.05);与对照组比较,研究组血红蛋白减少、肝肾功能损伤、恶心呕吐、中性粒细胞减少发生率之间比较差异无统计学意义(P>0.05)。结论联合采取调强放疗及血管内皮抑制素治疗老年中晚期NSCLC,可有效提高肿瘤控制率,改善患者生存状况,可能是因其能降低血清肿瘤标志物水平,减轻对免疫功能的�Objective To investigate the radiosensitization effect of endostatin combined with intensity-modulated radiotherapy in elderly patients with advanced non-small cell lung cancer NSCLC)and its effect on T cells and natural killer(NK)cells.Methods A total of 106 patients with NSCLC in our hospital from March 2015 to August 2016 were selected and divided into a study group and a control group according to a simple random number table method,53 cases in each group.The control group took intensity-modulated radiotherapy,and the study group took endostatin on the basis of the control group.The clinical efficacy,levels of NK cells and T cells,serum tumor marker levels,erythropoieth(EPO)mRNA,EPO-receptor mRNA levels before and after treatment,toxic and side effects were counted in the two groups.After 3 years of follow-up,the survival[median overall survival(OS),median progression-free survival(PFS)]of the two groups was counted.Results The tumor control rate of the study group(86.79%)was higher than that of the control group(69.81%)(P<0.05);after treatment,the NK cells,CD3±,CD4^+,CD4^+/CD8^+in the two groups were lower than before treatment,and CD8^+was higher than before treatment.However,NK cells(10.44±2.13)%,CD3±(59.33±5.15)%,CD4^+(36.40±3.86)%,and CD4^+/CD8^+(1.23±0.30)in the study group were higher than those in the control group,CD8^+(29.56±2.50)%was lower than the control group(P<0.05);after treatment,the serum levels of CA199,CA125,CEA and CY211 in the two groups were lower than before treatment.And the CA199(30.15±4.14)kU/L,CA125(29.77±5.30)kU/L,CEA(17.97±4.10)μg/L,CY211(4.56±1.34)μg/L of the study group were lower than those of the control group(P<0.05);after treatment,the levels of EPO mRNA and EPO-R mRNA in the two groups were lower than before treatment.EPO mRNA(0.80±0.06)and EPO-R mRNA(0.81±0.08)in the study group were lower than those in the control group(P<0.05);the incidence of hemoglobin reduction,liver and kidney function damage,vomiting and nausea,neutropenia between the study group and

关 键 词：血管内皮抑制素 调强放疗 非小细胞肺癌 T细胞 NK细胞 

分 类 号：R734.2[医药卫生—肿瘤]