摘要
目的分析奥希替尼联合调强放射治疗(IMRT)应用于非小细胞肺癌(NSCLC)中的疾病控制效果及对患者免疫功能的影响。方法选取NSCLC患者84例为研究对象,依照入院时间先后顺序分为对照组、研究组,两组样本数量均为42例。对照组施以IMRT,研究组在IMRT基础上给予奥希替尼治疗。比较两组患者治疗前后血管生成指标[胸苷激酶1(TK1)、血管内皮生长因子(VEGF)]与肿瘤标志物[细胞角蛋白19片段抗原(CYFRA21-1)、糖类抗原125(CA125)]水平,治疗前后T细胞亚群水平,治疗6个月后肿瘤控制率及不良事件发生情况。结果两组治疗前血管生成指标、肿瘤标志物水平组间比较不存在显著差异,无统计学意义(P>0.05);治疗6个月后,研究组患者血管生成物指标VEGF(549.26±85.16)pg/ml、TK1(0.81±0.05)pmol/L及肿瘤标志物CYFRA21-1(7.26±2.14)U/ml、CA125(36.38±6.03)U/ml较对照组的(759.24±90.31)pg/ml、(1.12±0.08)pmol/L、(9.52±2.37)U/ml、(44.85±7.83)U/mll更低,组间比较差异具有统计学意义(P<0.05)。治疗前两组患者T细胞亚群水平及CD4^(+)T/CD8^(+)T比较不存在显著差异,结果无统计学意义(P>0.05);治疗6个月后,研究组患者CD3^(+)T细胞(78.91±6.39)%、CD4^(+)T细胞(45.28±5.21)%及CD4^(+)T/CD8^(+)T(2.21±0.49)均高于对照组的(62.75±6.12)%、(36.52±4.28)%、(1.51±0.40),CD8^(+)T细胞(20.45±2.26)%低于对照组的(24.03±2.30)%,组间比较差异具有统计学意义(P<0.05)。治疗6个月后,研究组的肿瘤总控制率为66.67%,超过对照组的35.71%,差异均存在统计学意义(P<0.05);研究组患者的不良事件总发生率为11.90%,与对照组(14.29%)相比,结果无统计学意义(P>0.05)。结论在NSCLC患者实施IMRT治疗的过程中联合应用奥希替尼对其血管生成指标及肿瘤标志物水平具有显著的降低效果,并能有效提高肿瘤控制率、改善免疫功能,且有良好的安全性。
Objective To analyze the disease control effect of osimertinib combined with intensity modulated radiation therapy(IMRT)in non small cell lung cancer(NSCLC)and its impact on the immune function of patients.Methods A total of 84 NSCLC patients were selected as the research subjects and divided into the control group and the study group according to the order of admission,with 42 cases in each group.The control group was treated with IMRT,while the study group was given osimertinib on the basis of IMRT.Patients in both groups were compared in terms of levels of angiogenesis indicators[thymidine kinase 1(TK1),vascular endothelial growth factor(VEGF)]and tumor markers[cytokeratin 19 fragment(CYFRA21-1),carbohydrate antigen 125(CA125)]and T cell subsets before and after treatment,tumor control rate after 6 months of treatment,and occurrence of adverse events.Results There was no significant difference in angiogenesis indicators and tumor marker levels between the two groups before treatment,and there was no statistical significance(P>0.05);After 6 months of treatment,the angiogenic markers VEGF(549.26±85.16)pg/ml,TK1(0.81±0.05)pmol/L,and tumor markers CYFRA21-1(7.26±2.14)U/ml and CA125(36.38±6.03)U/ml were significantly lower in the study group compared with those in the control group[(759.24±90.31)pg/ml,(1.12±0.08)pmol/L,(9.52±2.37)U/ml,and(44.85±7.83)U/ml],and the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of T cell subsets and CD4^(+)T/CD8^(+)T between the two groups of patients,and the results were not statistically significant(P>0.05).After 6 months of treatment,the study group had CD3^(+)T cells of(78.91±6.39)%,CD4^(+)T cells of(45.28±5.21)%,and CD4^(+)T/CD8^(+)T of(2.21±0.49),which were higher than those in the control group[(62.75±6.12)%,(36.52±4.28)%,and(1.51±0.40)];the study group had a lower CD8^(+)T cells of(20.45±2.26)%than(24.03±2.30)%in the control group;the differences were all statistically significant(P<0.05).After 6 months of treatment,the tumor control rate of the study group was 66.67%,which was higher than 35.71%of the control group.The difference was statistically significant(P<0.05).The total incidence of adverse events in the study group was 11.90%,which was not statistically significant compared to the control group(14.29%)(P>0.05).Conclusion The combined use of osimertinib in IMRT treatment of NSCLC patients has a significant effect on reducing the levels of angiogenesis indicators and tumor markers,and can effectively increase the tumor control rate,improve immune function,and has good safety.
作者
刘志敏
段虎平
黄永辉
于洋
LIU Zhi-min;DUAN Hu-ping;HUANG Yong-hui(Department of Oncology,Baiyin First People's Hospital,Baiyin 730900,China)
出处
《中国实用医药》
2025年第20期6-10,共5页
China Practical Medicine
关键词
奥希替尼
调强放射治疗
非小细胞肺癌
疾病控制
免疫功能
Osimertinib
Intensity modulated radiation therapy
Non small cell lung cancer
Disease control
Immune function
作者简介
通讯作者:于洋。
