放疗联合热疗治疗非小细胞肺癌的疗效观察及VEGF、sIL-2R、IL-6的变化意义

目的探讨放疗联合热疗对肺癌的疗效及对VEGF、sIL-2R、IL-6的影响和意义。方法 60例患者随机分为两组,每组各30例,一组为放疗联合热疗组,另一组为单纯放疗组。观察临床疗效、毒副反应,以及治疗前后血清VEGF、sIL-2R、IL-6的变化。结果热放疗组局部病灶缓解程度明显好于单纯放疗组;与单纯放疗组比较,胸痛及严重咳嗽缓解率差异有显著性,两组副作用比较差异无显著性;热放疗组中VEGF治疗前、治疗后2周、治疗后2个月变化不明显,单纯放疗组中VEGF呈进行性升高,治疗后两周与治疗前比较无统计学差异,但治疗后两个月与治疗前比较差异有显著性。两组组间比较则差异无显著性;热放疗与单纯放疗均使sIL-2R明显下降,两组治疗后2周、治疗后2个月与治疗前比较差异有显著性,治疗后2个月与治疗后2周比较差异均有显著性,热放疗组的变化高于单纯放疗组,两组组间比较差异有显著性;治疗前两组IL-6浓度差异无显著性,热放疗组治疗后2周、治疗后2个月均高于治疗前,治疗后2个月更为显著,单纯放疗组中只有治疗后2个月与治疗前差异有显著性。结论放疗加热疗与单纯的放疗相比较,可使分期较晚的非小细胞肺癌获得较好的局部病灶缓解,同时明显改善了伴随症状,提高了患者的生活质量。

Observation on efficacy of radiotherapy combined with hyperthermia in treatment of non-small-cell lung cancer and significance of change of VEGF,sIL-2R and IL-6

Objective To evaluate the efficacy of radiotherapy and hyperthermia in treatment of advanced non-small-cell lung cancer（NSCLC） and to analyse the change and clinic significance of serum VEGF,sIL-2R and IL-6 levels before and after radiotherapy and hyperthermia.Methods Sixty patients with advanced NSCLC were randomly divided into two groups,30 received radiotherapy and hyperthermia,30 received radiotherapy only.The efficacy and toxicity of radiotherapy and hyperthermia in treatment of advanced NSCLC and the changes of serum VEGF,sIL-2R,IL-6 levels before and after radiotherapy and hyperthermia were observed.Results The local response rate in the radiotherapy combined with hyperthermia group was higher than that in the radiotherapy only group.There was a significant difference in the response rates of chest pain and severe cough in radiotherapy combined with hyperthermia group compared with control group.There was no significant difference between the two groups in side-effects.The serum VEGF levels in the 2nd month after the treatment did not significantly change compared with the serum VEGF levels before treatment and the 2nd week after the treatment in radiotherapy combined with hyperthermia group,while there was a progressive increase in the serum VEGF levels in the radiotherapy only group,there was significant difference in the serum VEGF levels between the 2nd month after the treatment and before treatment.There was no significant difference between two groups.The level of sIL-2R was significantly progressively decreased in both group.The change of the level of sIL-2R in the radiotherapy combined with hyperthermia was more significant than that in the radiotherapy only group,the two groups had significant differences.The serum IL-6 level progressively increased in the radiotherapy combined with hyperthermia group.There was significant difference in the serum IL-6 levels between the 2nd month after the treatment and before treatment in the radiotherapy only group.Conclusions Radiotherapy combined with hyperthermia was better than radiotherapy alone in local response rate.Radiotherapy combined with hyperthermia not only can significantly elevate the quality of life in patients with advanced NSCLC,but also improves accompanying symptoms.