不同放疗方法对食管癌患者细胞免疫功能及应激激素水平的影响  

Effects of Different Radiotherapy Methods on Cellular Immune Function and Stress Hormone Levels in Patients with Esophageal Cancer

作　　者：张森[1] 华松 王旸[1] 余杰[1] 张凯[1] 万里新[1] 惠双 ZHANG Sen;HUA Song;WANG Yang(Nanyang Hospital Affiliated to Zhengzhou University(Nanyang Central Hospital ),Nanyang,473009)

机构地区：[1]郑州大学附属南阳医院,南阳市中心医院,473009

出　　处：《实用癌症杂志》2021年第2期271-274,279,共5页The Practical Journal of Cancer

基　　金：河南省科技厅科技攻关项目(编号:112102311208)。

摘　　要：目的对比不同放疗方法对食管癌患者细胞免疫功能及应激激素水平的影响。方法将中晚期食管癌患者120例,根据随机数字表法分为观察组与对照组,各60例。对照组给予常规适行放疗,观察组给予三维适型调强放疗,两组都治疗观察6~7周,记录细胞免疫功能及应激激素水平变化情况。结果放疗后观察组总有效率为96.7%,显著低于对照组的81.7%(P<0.05)。观察组放疗期间皮肤反应、消化道反应、放射性食管炎、骨髓抑制等并发症发生率都显著低于对照组(P<0.05)。观察组放疗后的CD3+/CD4+、CD4+/CD8+T细胞比例与放疗前对比差异无统计学意义(P>0.05),对照组放疗后低于放疗前(P<0.05),且治疗后观察组以上T细胞比例显著高于对照组(P<0.05)。两组放疗后的血清生长激素(grow hormone,GH)、催乳素(prolactin,PRL)值低于放疗前,观察组低于对照组,对比差异都有统计学意义(P<0.05)。结论相对于传统放疗,三维适型调强放疗在食管癌患者中的应用有利于保持机体细胞免疫功能,降低应激激素的表达,从而提高治疗效果,减少并发症的发生。Objective To compare the effects of different radiotherapy methods on cellular immune function and stress hormone levels in patients with esophageal cancer.Methods According to the random number table method,120 patients with advanced esophageal cancer were divided into the observation group and the control group,each with 60 cases.The control group were given conventional radiotherapy,and the observation group were given three-dimensional conformal intensity modulated radiotherapy.Both groups were treated and observed for6-7 weeks,and the changes of cellular immune function and stress hormone levels were recorded.Results The total effective rates of the observation group after radiotherapy were 96.7%,which were significantly lower than 81.7%of the control group(P<0.05).The incidence rates of complications such as skin reactions,gastrointestinal reactions,radiation esophagitis,and bone marrow suppression in the observation group were significantly lower than those in the control group(P<0.05).The ratio of CD3+/CD4+,CD4+/CD8+T cells after radiotherapy in the observation group were not statistically significant compared with that before radiotherapy(P>0.05),and the proportion of T cells in the observation group was significantly higher than that in the control group after treatment(P<0.05),compared with the observation group were also statistically significant(P<0.05).The serum growth hormone(GH)and prolactin(PRL)values of the two groups after radiotherapy were lower than those before radiotherapy,and the observation group were lower than that of the control group that compared the difference were statistically significant(P<0.05).Conclusion Compared with traditional radiotherapy,the application of 3D IMRT in patients with esophageal cancer is conducive to maintaining the body's cellular immune function,it can reduce the expression of stress hormones,thereby improving the treatment effect and reduce the occurrence of complications.

关 键 词：三维适型调强放疗 食管癌 细胞免疫功能 应激激素 催乳素 

分 类 号：R735.1[医药卫生—肿瘤]