华蟾素胶囊对中晚期鼻咽癌放射治疗的增敏作用及对患者血清MIP-3α、cystatinA表达的影响  

Radiosensitization effect of cinobufacin capsule on intermediate and advanced nasopharyngeal carcinoma and its influence on serum MIP-3αand cystatinA expression

作　　者：高宏敏[1] 李建光[1] 刘建平[1] 蔡庆春[1] GAO Hongmin;LI Jianguang;LIU Jianping;CAI Qingchun(The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,Henan 450000,China)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450000

出　　处：《上海中医药杂志》2021年第7期45-49,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项(2018ZY1013)。

摘　　要：目的探讨华蟾素胶囊对中晚期鼻咽癌患者放射治疗的增敏作用及对血清巨噬细胞炎性蛋白-3α(MIP-3α)、半胱氨酸蛋白酶抑制剂A(cystatinA)表达的影响。方法将122例中晚期鼻咽癌患者随机分为观察组和对照组,每组61例。对照组患者行单纯放射治疗,观察组在单纯放射治疗的基础上加用华蟾素胶囊。两组疗程均为1个放射治疗周期,观察实体瘤疗效及不良反应发生情况,比较血清MIP-3α、cystatinA水平的变化情况,同时随访无进展生存期(PFS)及总生存期(OS),并采用多元线性回归进行预后影响因素分析。结果①观察组脱落2例,对照组脱落1例,最终完成试验者119例,其中观察组59例、对照组60例。②治疗后、治疗后1个月观察组总有效率分别为86.44%、77.97%,对照组分别为71.67%、60.00%;治疗后、治疗后1个月组间实体瘤疗效比较,观察组优于对照组(P<0.05)。③治疗前后组内比较,两组血清MIP-3α、cystatinA水平降低(P<0.05);组间治疗后比较,观察组MIP-3α、cystatinA水平低于对照组(P<0.05)。④在不良反应方面,观察组鼻咽部不适程度轻于对照组(P<0.05)。⑤观察组PFS显著高于对照组(χ^(2)=4.266,P=0.039),两组OS比较,差异无统计学意义(χ^(2)=0.834,P=0.361)。⑥Cox多因素分析结果显示,联合华蟾素治疗是鼻咽癌预后的独立保护因素。结论华蟾素可提高中晚期鼻咽癌患者放射治疗的敏感性,减轻放疗不良反应,延长患者PFS,其机制可能与调节MIP-3α、cystatinA表达有关。Objective To investigate the radiosensitization effect of cinobufacin capsule on patients with intermediate and advanced nasopharyngeal carcinoma undergoing radiotherapy and its influence on the expression of serum macrophage inflammatory protein-3α(MIP-3α)and cystatinA.Methods A total of 122 patients with intermediate and advanced nasopharyngeal carcinoma were randomly divided into observation group(n=61)and control group(n=61).Patients in the control group were administered with radiotherapy alone,while patients in the observation group were additionally administered with cinobufacin capsules besides radiotherapy.The treatment course of the two groups was one radiotherapy cycle.The therapeutic effects on solid tumors and adverse reactions were observed,and the changes of serum MIP-3αand cystatinA levels were compared.Meanwhile,the progression-free survival(PFS)and overall survival(OS)were followed up,and multiple linear regression(MLR)was used to analyze the influencing factors of prognosis.Results①There were 2 drop-out cases in the observation group and 1 drop-out case in the control group,and 119 cases finally completed the trial,including 59 cases in the observation group and 60 cases in the control group.②The total effective rate of the observation group was 86.44%at the end of treatment and 77.97%one month after treatment,while that of the control group was 71.67%and 60.00%respectively.At the end of treatment and one month after treatment,the therapeutic effect on solid tumors in the observation group was better than that in the control group(P<0.05).③According to the intra-group comparison before and after treatment,the levels of serum MIP-3αand cystatinA in both groups decreased(P<0.05);According to the inter-group comparison after treatment,the levels of MIP-3αand cystatinA in the observation group were lower than those in the control group(P<0.05).④In terms of adverse reactions,the nasopharyngeal discomfort degree in the observation group was milder than that in the control group(P<0.05).�

关 键 词：鼻咽癌 放射治疗 华蟾素 巨噬细胞炎性蛋白-3α 半胱氨酸蛋白酶抑制剂A 

分 类 号：R273[医药卫生—中西医结合]