| 立体定向放疗治疗非小细胞肺癌的免疫与肿瘤标志物变化及近期疗效影响因素 |
| 投稿时间：2017-04-27 修订日期：2017-05-26 点此下载全文 |
| 引用本文：王海霞,单国用,刘兴安,侯继院,龚哲.立体定向放疗治疗非小细胞肺癌的免疫与肿瘤标志物变化及近期疗效影响因素[J].医学研究杂志,2018,47(2):119-123 |
| DOI：
10.11969/j.issn.1673-548X.2018.02.028 |
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| 基金项目:河南省医学科技攻关计划项目（201602078） |
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| 中文摘要:目的 探析立体定向放疗治疗非小细胞肺癌的免疫与肿瘤标志物变化及近期疗效影响因素。方法 回顾性分析130例非小细胞肺癌患者的临床资料，根据患者治疗方案分为IMRT组（采取逆向调强放疗，n=70）与3D-CRT组（采取三维适形放疗，n=60）。比较两组总有效率与治疗前后的血清CA125、CA153、CA199、CEA水平、T细胞亚群，采用多因素Logistic回归分析立体定向放疗治疗非小细胞肺癌的近期疗效影响因素。结果 IMRT组总有效率为72.86%，高于3D-CRT组55.00%（P<0.05）。两组治疗后的血清CA125、CA153、CA199、CEA水平较治疗前均降低（P<0.05），同时IMRT组治疗后的血清CA125、CA153、CA199、CEA水平低于3D-CRT组（P<0.05）。两组治疗后的CD3+、CD4+、CD4+/CD8+均较治疗前下降、CD8+较治疗前升高（P均<0.05），IMRT组治疗后的CD3+、CD4+、CD4+/CD8+高于3D-CRT组、CD8+低于3D-CRT组（P均<0.05）。多因素Logistic回归分析结果显示年龄>65岁、CA125阳性、CA153阳性、CA199阳性、CEA阳性等为近期疗效不佳的独立危险因素（P<0.05）。结论 立体定向放疗治疗非小细胞肺癌可取得良好效果，其中年龄>65岁、CA125、CA153、CA199、CEA阳性为近期疗效的不利影响。 |
| 中文关键词:立体定向放疗 非小细胞肺癌 近期疗效 肿瘤标志物 |
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| Changes of Immune and Tumor Markers in Patients with Non-small Cell Lung Cancer by Stereotactic Radiotherapy and Its Recent Influential Factors |
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| Abstract:Objective To investigate the changes of immunity and tumor markers in patients with non-small cell lung cancer treated by stereotactic radiotherapy and the effect of short-term efficacy.Methods Retrospective analysis of 130 cases of non-small cell lung cancer in patients with clinical data was performed. Patients were divided into IMRT group(treated with intensity-modulated radiation therapy,n=70) and 3D-CRT group (treated with three-dimensional radiation therapy,n=60) according to the treatment regimen. The total effective rate of the two groups, the serum levels of CA125, CA153, CA199, CEA and T cell subsets before and after treatment were compared between the two groups.Multivariate logistic regression analysis was used to analyze the factors influencing the efficacy of stereotactic radiotherapy in the treatment of non-small cell lung cancer.Results The total effective rate was 72.86% in the IMRT group and 55.00% in the 3D-CRT group (P<0.05). The levels of serum CA125, CA153, CA199 and CEA after treatment in two groups were significantly decreased than before treatment(P<0.05). The levels of serum CA125, CA153, CA199 and CEA after treatment in the IMRT group were lower than those in the 3D-CRT group (P<0.05). The CD3+, CD4+, CD4+/CD8+ were decreased and the CD8+ were increased after treatment than before treatment in both groups(all P<0.05). The CD3+, CD4+, CD4+/CD8+ after treatment in the IMRT group were higher than those in the 3D-CRT group, and the CD8+ was lower than than of the 3D-CRT group(all P<0.05). Multivariate logistic regression analysis showed that age>65 years old, CA125 positive, CA153 positive, CA199 positive and CEA positive were the independent risk factors (P<0.05).Conclusion Stereotactic radiotherapy for non-small cell lung cancer can achieve good results, including age>65 years old, CA125, CA153, CA199, CEA positive for the adverse effects of short-term efficacy. |
| keywords:Stereotactic radiotherapy Non-small cell lung cancer Short-term efficacy Tumor markers |
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