全程热疗治疗鼻咽癌颈部转移淋巴结的疗效及对免疫功能的影响  

Efficacy of whole course hyperthermia on cervical metastatic lymph nodes of nasopharyngeal carcinoma and its effects on immune function

作　　者：罗焱 谢悦 李晓宇 闫瑾 刘德清 王雨晴 杨丽娜 王颖 LUO Yan;XIE Yue;LI Xiaoyu;YAN Jin;LIU Deqing;WANG Yuqing;YANG Li’na;WANG Ying(Department of Radiotherapy,Affiliated Tumor Hospital of Chongqing University,Chongqing 400030,China)

机构地区：[1]重庆大学附属肿瘤医院放疗科,重庆400030

出　　处：《重庆医学》2023年第23期3567-3571,共5页Chongqing medicine

基　　金：国家自然科学基金项目(82272755);重庆市自然科学基金项目(2022NSCQ-MSX0706);重庆市沙坪坝区科技局决策咨询与管理创新项目(Jcd202279)。

摘　　要：目的探讨局部晚期鼻咽癌诱导化疗及同步放化疗期间联合颈部转移淋巴结热疗的近期疗效及对外周血淋巴细胞亚群的影响。方法收集2021年7月至2022年7月该院病理确诊的60例局部晚期鼻咽癌患者为研究对象,根据治疗方式的不同分为观察组(诱导化疗^(+)同步放化疗联合热疗)和对照组(诱导化疗^(+)同步放化疗),每组30例。记录并比较两组一般情况、近期疗效、EB病毒(EBV)DNA水平、不良反应发生情况、外周血淋巴细胞亚群和热休克蛋白90α(HSP90α)水平。结果与对照组比较,观察组客观缓解率更高(100%vs.90.0%),诱导化疗后EBV阳性率更低(20.0%vs.46.7%),≥3级的放射性皮炎发生率更高(30.0%vs.6.7%),放疗后自然杀伤(NK)细胞水平更高[(25.89±5.53)%vs.(19.18±6.41)%],治疗后HSP90α水平更高[(91.19±9.18)ng/mL vs.(67.22±11.02)ng/mL],差异有统计学意义(P<0.05)。与治疗前比较,放疗后观察组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平下降,对照组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平下降(P<0.05),但两组比较差异无统计学意义(P>0.05)。结论热疗可提高鼻咽癌颈部转移淋巴结局控,改善免疫功能。Objective To study the short-term efficacy of combined cervical metastatic lymph nodes hyperthermia during locally advanced nasopharyngeal carcinoma induction chemotherapy and concurrent chemoradiotherapy and its effect on peripheral blood lymphocyte subsets.Methods Sixty patients with pathologically diagnosed nasopharyngeal carcinoma in this hospital from July 2021 to July 2022 were collected as the study subjects and divided into the observation group(induction chemotherapy^(+)concurrent chemoradiotherapy combined with hyperthermia)and control group(induction chemotherapy^(+)concurrent chemoradiotherapy),30 cases in each group.The general information,short term efficacy,EB virus(EBV)DNA level,adverse reactions occurrence,peripheral blood lymph cell subsets and hot shock protein 90α(HSP90α)were recorded and compared between the two groups.Results Compared with the control group,the objective remission rate in the observation group was higher(100.0%vs.90.0%),the EBV positive rate after induction chemotherapy was lower(20.0%vs.46.7%),the occurrence rate of≥3 grade radiation dermatitis was higher(30.0%vs.6.7%),the level of natural killer(NK)cells after radiotherapy was increased[(25.89±5.53)%vs.(19.18±6.41)%],the HSP90αlevel after treatment was increased[(91.19±9.18)ng/mL vs.(67.22±11.02)ng/mL],and the differences were statistically significant(P<0.05).Compared with before treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)after radiotherapy in the observation group were decreased,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the control group were decreased,but the differences between the two groups were not statistically significant(P<0.05),while the proportion of peripheral blood NK cells in the experimental group was significantly increased compared with the control group(P<0.05).Conclusion Hyperthermia canimprove the local control of nasopharyngeal carcinoma cervical lymph node metastasis and improve the immune function.

关 键 词：热疗 同步放化疗 鼻咽癌 免疫功能 淋巴细胞亚群 

分 类 号：R739.63[医药卫生—肿瘤]