国际肿瘤学杂志

国际肿瘤学杂志 ›› 2019, Vol. 46 ›› Issue (11): 662-667.doi: 10.3760/cma.j.issn.1673-422X.2019.11.004

• 论著 • 上一篇    下一篇

3D-CRT联合PC化疗治疗非小细胞肺癌患者的疗效及对血清CA125、TIMP-1、SAA水平及免疫功能的影响#br#

王永存1胡文铧2陈华林1林炯1赖振南1梁亚海1吴爱兵1杨志雄1   

  1. 1广东医科大学附属医院肿瘤中心一区，湛江524000；2广东医科大学附属医院临床病理科，湛江524000
  • 出版日期:2019-11-08 发布日期:2019-12-26
  • 通讯作者: 杨志雄 E-mail:yangzhixiong068@126.com

Effect of 3D-CRT combined with PC chemotherapy on non-small cell lung cancer patients and serum CA125, TIMP-1, SAA levels and immune function

Wang Yongcun1, Hu Wenhua2, Chen Hualin1, Lin Jiong1, Lai Zhennan1, Liang Yahai1, Wu Aibing1, Yang Zhixiong   

  1. 1First District of Oncology Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China; 2Department of Clinical Pathology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China
  • Online:2019-11-08 Published:2019-12-26
  • Contact: Yang Zhixiong E-mail:yangzhixiong068@126.com

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摘要： 目的探讨三维适形放疗（3D-CRT）联合PC化疗（紫杉醇+卡铂）对非小细胞肺癌(NSCLC)患者的疗效及对血清CA125、金属蛋白酶组织抑制因子-1（TIMP-1）、血清淀粉样蛋白A（SAA）水平以及T细胞亚群水平的影响。方法以2015年5月至2017年12月在广东医科大学附属医院进行治疗的100例NSCLC患者作为研究对象，依据随机数字表法分为对照组和观察组，每组50例。观察组患者采取3D-CRT联合PC化疗治疗，对照组患者采取PC化疗治疗，两组患者治疗4个周期。比较两组患者的治疗效果、血清CA125、TIMP-1、SAA水平、T细胞亚群水平以及不良反应之间的差异。结果观察组和对照组各失访4例。观察组患者的总有效率（43.48%，20/46）显著高于对照组（23.91%，11/46；χ2=3.941，P=0.047）。观察组和对照组患者治疗前血清CA125、TIMP-1、SAA水平差异无统计学意义，治疗后各指标水平均较治疗前下降，观察组分别为（12.31±1.13）U/ml、（275.31±13.69）pg/ml、（47.21±7.21）mg/L，对照组分别为（30.36±1.98）U/ml、（320.36±17.23）pg/ml、（65.92±8.36）mg/L，观察组显著低于对照组（t=53.699，P＜0.001；t=13.884，P＜0.001；t=11.495，P＜0.001）。观察组和对照组患者治疗前CD3+、CD4+、CD8+、CD4+/CD8+水平差异无统计学意义，治疗后各指标水平均较治疗前降低，观察组分别为（35.27±10.31）%、（20.27±6.72）%、（15.89±3.37）%、0.91±0.37，对照组分别为（30.77±9.27）%、（15.27±5.73）%、（12.02±2.69）%、0.75±0.39，观察组显著高于对照组（t=2.201，P=0.030；t=3.840，P＜0.001；t=6.087，P＜0.001；t=2.019，P=0.047）。观察组和对照组患者恶心呕吐［63.04%（29/46） vs. 43.48%（20/46）；χ2=3.537，P=0.060］、静脉炎［6.52%（3/46） vs. 4.35%（2/46）；χ2=0.000，P＞0.999］、肝功能异常［6.52%（3/46） vs. 2.17%（1/46）；χ2=0.261，P=0.609］、骨髓抑制［8.70%（4/46） vs. 6.52%（3/46）；χ2=0.000，P＞0.999］不良反应发生率差异无统计学意义。结论NSCLC患者通过3D-CRT联合PC化疗治疗，总有效率得到提高，血清CA125、TIMP-1、SAA水平下降，患者的免疫功能得到一定恢复，疗效显著，安全性较好，该治疗方案适合NSCLC治疗。

关键词: 癌, 非小细胞肺, 药物疗法, 三维适形放疗, 金属蛋白酶组织抑制因子-1

Abstract: ObjectiveTo investigate the effect of three-dimensional conformal radiotherapy (3D-CRT) combined with PC chemotherapy (paclitaxel + carboplatin) on non-small cell lung cancer (NSCLC) patients and the serum levels of CA125, tissue inhibitor of metalloproteinase-1 (TIMP-1), serum amyloid A (SAA) and T-lymphocyte subsets. MethodsA total of 100 patients with NSCLC treated in Affiliated Hospital of Guangdong Medical University from May 2015 to December 2017 were selected as the study subjects. They were divided into control group and observation group according to random number table method, with 50 cases in each group. The observation group was treated with 3D-CRT combined with PC chemotherapy, while the control group was treated with PC chemotherapy. The two groups were treated for 4 cycles. The therapeutic effect, serum CA125, TIMP-1, SAA, T-lymphocyte subsets and adverse reactions were compared between the two groups. ResultsFour cases were lost to follow-up both in the two groups. The overall response  rate in the observation group (43.48%, 20/46) was higher than that in the control group (23.91%, 11/46; χ2=3.941, P=0.047). The serum levels of CA125, TIMP-1 and SAA of the two groups had no significant difference before treatment, and the levels of these indexes decreased after treatment. The serum levels of CA125, TIMP-1 and SAA in the observation group after treatment were (12.31±1.13) U/ml, (275.31±13.69) pg/ml and (47.21±7.21) mg/L, which were lower than those in the control group ［(30.36±1.98) U/ml, (320.36±17.23) pg/ml, (65.92±8.36) mg/L］, with significant differences (t=53.699, P＜0.001; t=13.884, P＜0.001; t=11.495, P＜0.001). The levels of CD3+, CD4+, CD8+ and CD4+/CD8+ of the two groups had no significant difference before treatment, and the levels of these indexes decreased after treatment. The levels of CD3+, CD4+, CD8+ and CD4+/CD8+ in the observation group were (35.27±10.31)%, (20.27±6.72)%, (15.89±3.37)% and 0.91±0.37, which were higher than those in the control group ［(30.77±9.27)%, (15.27±5.73)%, (12.02±2.69)% and 0.75±0.39］, with significant differences (t=2.201, P=0.030; t=3.840, P＜0.001; t=6.087, P＜0.001; t=2.019, P=0.047). There were no significant differences in the adverse reactions such as nausea and vomiting ［63.04% (29/46) vs. 43.48% (20/46); χ2=3.537, P=0.060］, phlebitis ［6.52% (3/46) vs. 4.35% (2/46); χ2=0.000, P＞0.999］, abnormal liver function ［6.52% (3/46) vs. 2.17% (1/46); χ2=0.261, P=0.609］ and myelosuppression ［8.70% (4/46) vs. 6.52% (3/46); χ2=0.000, P＞0.999］ between the observation group and the control group. ConclusionFor patients with NSCLC, 3D-CRT combined with PC chemotherapy can improve the overall response rate, decrease the levels of serum CA125, TIMP-1 and SAA, and improve the immune function of patients. The therapeutic effect is remarkable and the safety is good. The therapeutic scheme is suitable for the treatment of NSCLC.

Key words: Carcinoma, non-small-cell lung, Drug therapy, Three-dimensional conformal radiotherapy, Tissue inhibitor of metalloproteinase-1