摘要
目的 探讨大分割放疗联合顺铂+依托泊苷(EP)化疗治疗局限期小细胞肺癌(LS-SCLC)的效果及对免疫功能的影响.方法 100 例LS-SCLC患者,采用随机数字表法分为对照组和观察组,每组 50 例.对照组给予超分割放疗+EP化疗治疗,观察组给予大分割放疗+EP化疗治疗.比较两组疗效,治疗前后免疫功能指标[CD3+、CD4+、CD8+、CD4+/CD8+、自然杀伤细胞(NK)],无进展生存时间、总生存时间、2 年生存率及不良事件发生率.结果 观察组总有效率为 80.00%,高于对照组的 58.00%(P<0.05).治疗后,两组CD3+、CD4+、CD4+/CD8+及NK细胞均升高,且观察组CD3+(66.21±4.06)%、CD4+(43.10±3.09)%、CD4+/CD8+(1.72±0.19)及NK细胞(15.12±2.74)%高于对照组的(62.18±3.62)%、(39.16±2.99)%、(1.32±0.24)、(12.07±2.17)%;CD8+均降低,且观察组CD8+(21.09±2.75)%低于对照组的(24.72±2.65)%(P<0.05).观察组无进展生存时间(12.98±2.19)个月、总生存时间(20.19±3.27)个月长于对照组的(8.27±1.98)、(14.29±2.91)个月,2 年生存率 68.00%高于对照组的 42.00%(P<0.05).观察组不良事件发生率 22.00%略低于对照组的 32.00%,但差异不明显(P>0.05).结论 大分割放疗联合EP化疗治疗LS-SCLC的效果显著,可有效调节机体免疫功能,延长患者的生存期并提高生存率,安全性高,可在临床推广运用.
Abstract
Objective To explore the effect of high-dose radiotherapy combined with etoposide(EP)chemotherapy on limited-stage small cell lung cancer(LS-SCLC)and its impact on immune function.Methods 100 cases of LS-SCLC patients were divided into a control group and an observation group using a random number table method,with 50 patients in each group.The control group was treated with hyperfractionated radiotherapy and EP chemotherapy,while the observation group was treated with high-dose radiotherapy and EP chemotherapy.The effects,immune function indicators[CD3+,CD4+,CD8+,CD4+/CD8+,natural killer cell(NK)]before and after treatment,and the progression-free survival time,total survival time,2-year survival rate and incidence of adverse events of the two groups were compared.Results The total effective rate of the observation group was 80.00%,which was higher than 58.00%of the control group(P<0.05).After treatment,CD3+,CD4+,CD4+/CD8+and NK cells increased in both groups,and CD8+decreased in both groups;the observation group had CD3+of(66.21±4.06)%,CD4+of(43.10±3.09)%,CD4+/CD8+of(1.72±0.19),and NK cells of(15.12±2.74)%,which were higher than(62.18±3.62)%,(39.16±2.99)%,(1.32±0.24),and(12.07±2.17)%in the control group;the observation group had lower CD8+of(21.09±2.75)%than(24.72±2.65)%in the control group(P<0.05).The progression-free survival time and overall survival time of the observation group were(12.98±2.19)and(20.19±3.27)months,which were longer than(8.27±1.98)and(14.29±2.91)months of the control group;the observation group had higher 2-year survival rate of 68.00%than 42.00%in the control group(P<0.05).The incidence of adverse events in the observation group was 22.00%,which was slightly lower than 32.00%in the control group,but the difference was not significant(P>0.05).Conclusion High-dose radiotherapy and EP chemotherapy have significant effects on the treatment of LS-SCLC,which can effectively regulate the body's immune function,prolong the patient's survival period,and improve survival rate,and they have high safety and can be widely used in clinical practice.
维普
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