125I粒子植入联合吉非替尼治疗非小细胞肺癌的临床疗效及对免疫系统的影响

目的 探讨125I粒子植入联合吉非替尼治疗非小细胞肺癌的临床疗效及对免疫系统的影响.方法 选取53例非小细胞肺癌患者为研究对象,均接受125I粒子植入联合吉非替尼治疗.对所有患者进行疗效和不良反应评价,同时测定治疗前及治疗后1、3、6个月时患者外周血T淋巴细胞亚群、NK细胞、CIK细胞及相关免疫调节因子的水平变化.结果 治疗后1、3、6个月的有效率分别为54.72%、64.15%、75.47%.术后1例患者出现粒子脱靶和迁移,1例患者出现气胸,2例患者出现咯血,所有患者均未出现白细胞减少和放射性肺损伤,本组治疗未出现其他严重并发症.治疗后6个月患者的外周血CD4+、CD4+/CD8+、NK细胞水平均较治疗前升高(P<0.05),CD8+水平较治疗前降低(P<0.05).治疗后6个月患者的外周血TNF-α、IL-2、IL-4、IL-6、IL-10水平均较治疗前降低(P<0.05).结论 125I粒子植入联合吉非替尼治疗非小细胞肺癌的临床疗效较好,治疗后不良反应发生率较低,同时可以调节患者T淋巴细胞亚群、NK细胞及免疫调节因子的表达,改善患者的免疫功能.

Clinical efficacy of 125I seed implantation combined with gefitinib in patients with non-small cell lung cancer and its impact on immune system

Objective To evaluate the clinical efficacy of 125I seed implantation combined with gefitinib in patients with non-small cell lung cancer and its impact on immune system. Methods 53 cases of patients with non-small cell lung cancer were selected, and all patients were treated with the therapy of 125I seed implantation combined with gefitinib. After treatment, the clinical efficacy and adverse reactions of all patients were evaluated. The levels of peripheral blood T-lymphocyte subpopulations, NK cells, CIK cells and related immunoregulatory factors before treatment and 1, 3 and 6 months after treatment were measured, and the changes were evaluated. Results The clinical efficacy of 1, 3 and 6 months after treatment is 54.72%, 64.15%and 75.47%respectively. After treatment, iodine seeds got out of the target ar-ea and migrated in one patient, pneumothorax occurred in one patient and hemoptysis occurred in two patients. None of the patients showed radiation injury of the lung, leukopenia or other serious complications. Comparing with data before treatment, the levels of peripheral blood CD4+, CD4+/CD8+and NK cells were higher (P<0.05) and the level of CD8+ was lower (P<0.05) at 6 months after treatment. The levels of peripheral blood TNF-α, IL-2, IL-4, IL-6 and IL-10 at 6 months after treatment were significantly lower than those before treatment (P<0.05). Conclusion In patients with non-small cell lung cancer, the therapy of 125I seed implantation combined with gefitinib showed good clinical efficacy and low rates of adverse reactions. It could also regulate T-lymphocyte subpopulations, NK cells and immunoregulatory factors, and im-prove immune function.