超分割放疗对局限期小细胞肺癌患者T淋巴细胞亚群和肿瘤标记物的影响  

Effect of hyperfractionated radiotherapy on T lymphocyte subsets and tumor markers in patients with limited-stage small cell lung cancer

作　　者：王泽伟 王伟佳 张洪岩 WANG Zewei;WANG Weijia;ZHANG Hongyan(Radiotherapy Department,Langfang Fourth People’s Hospital,Langfang,Hebei 065700,China;Radiotherapy Department,Hebei PetroChina Central Hospital,Langfang,Hebei 065700,China)

机构地区：[1]廊坊市第四人民医院放疗科,河北廊坊065700 [2]河北中石油中心医院放疗科,河北廊坊065700

出　　处：《临床肺科杂志》2023年第12期1788-1792,共5页Journal of Clinical Pulmonary Medicine

基　　金：廊坊市科技支撑计划项目(No.2018013158)。

摘　　要：目的探讨超分割放疗对局限期小细胞肺癌患者T淋巴细胞亚群和肿瘤标记物的影响。方法选取64例局限期小细胞肺癌患者,按照随机数字表法分成观察组与对照组,各32例。两组均给予化疗,对照组予常规分割放疗,观察组另予超分割放疗,比较两组T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)CD8^(+))、肿瘤标记物[(癌胚抗原(CEA)、糖类蛋白-125(CA-125)、细胞角蛋白19可溶性片段(CYFRA21-1)]水平,观察两组近期疗效、不良反应发生及生存时间。结果观察组治疗总有效率(87.50%)较对照组(65.63%)高(P<0.05);两组治疗后CD4^(+)、CD4^(+)CD8^(+)较治疗前升高,CD8^(+)较治疗前降低,观察组治疗后CD4^(+)、CD4^(+)CD8^(+)较对照组升高,CD8^(+)较对照组降低(P<0.05);两组治疗后CEA、CA-125、CYFRA21-1均较治疗前降低,观察组均较对照组降低(P<0.05);观察组放射性食管炎较对照组高(P<0.05);对照组生存时间中位数为21个月,95%CI 20.136~21.864,观察组生存时间为22个月,95%CI 20.385~23.615(χ^(2)=1.450,P=0.229)。结论超分割放疗治疗局限期小细胞肺癌患者疗效确切,可提高免疫功能,降低肿瘤标记物水平,出现放射性食管炎等毒性反应,但患者均可耐受,另超分割放疗无明显延长生存时间。Objective To investigate the effect of hyperfractionated radiotherapy on T lymphocyte subsets and tumor markers in patients with limited-stage small cell lung cancer.Methods 64 patients with limited-stage small cell lung cancer were selected and randomly divided into the observation group and the control group,with 32 patients in each group.Both groups received chemotherapy,the control group received conventional fractionated radiotherapy,and the observation group received hyperfractionated radiotherapy.The levels of T lymphocyte subsets(CD4^(+),CD8^(+),CD4^(+)CD8^(+)),tumor markers(carcinoembryonic antigen(CEA),carbohydrate protein-125(CA-125),and cytokeratin 19 soluble fragment(CYFRA21-1)were compared between the two groups.The short-term efficacy,adverse reactions,and survival time of the two groups were observed.Results The total effective rate of treatment of the observation group(87.50%)were higher than those of the control group(65.63%)(P<0.05).After treatment,CD4^(+)and CD4^(+)CD8^(+)in both groups increased compared before treatment,while CD8^(+)decreased compared before treatment,and the level of CD4^(+)and CD4^(+)CD8^(+)in the observation group was higher than that in the control group,while the value of CD8^(+)was lower than that in the control group(P<0.05).After treatment,CEA,CA-125,and CYFRA21-1 in both groups were lower than before treatment,and the observation group was lower than the control group(P<0.05).Radiation esophagitis in the observation group was higher than that in the control group(P<0.05).The median survival time in the control group was 21 months,with 95%CI=20.136 to 21.864.The survival time in the observation group was 22 months,with 95%CI=20.385 to 23.615(χ^(2)=1.450,P=0.229).Conclusion Hyperfractionated radiotherapy has a definite effect on patients with limited-stage small cell lung cancer,which can improve immune function,reduce the level of tumor markers,and develop toxic reactions such as radiation esophagitis,but patients can tolerate it.In addition,hyperfractionated radiot

关 键 词：超分割放疗 局限性小细胞肺癌 T淋巴细胞亚群 肿瘤标记物 

分 类 号：R734.2[医药卫生—肿瘤]