热疗与低剂量辐射对乳腺癌患者免疫功能的影响

目的 观察热疗联合低剂量辐射对乳腺癌患者造血和免疫功能的影响。方法 40例乳腺癌患者,随机分为常规化疗、热疗、低剂量辐射、热疗+低剂量辐射联合治疗4组,常规化疗组给予环磷酰胺(CTX)100 mg·m^-2,从第1天到第14天每天口服,甲氨喋呤(MTX)40 mg·m^-2,5-氟尿嘧啶(5-FU)600 mg·m^-2,于第1天及第8天静脉注射;热疗组于41℃静脉低流量灌注MTX 40 mg·m^-2,5-FU 600 mg·m^-2,恒温持续120 min;低剂量辐射组给予⁶⁰Coγ射线局部照射0.01 Gy/d,5次/周,3周;联合治疗组给予热疗+低剂量辐射治疗,方法同上。观察治疗后患者外周血象、IL-2、IL-4、TNF-γ、CD4、CD8水平的变化。结果 热疗、低剂量辐射、热疗+低剂量辐射联合治疗组IL-2、IL-4、TNF-γ、CD4、CD8水平均高于常规化疗组,热疗组、联合治疗组值均高于低剂量辐射组(P < 0.05),联合治疗组优于热疗组,但差异无统计学意义(P > 0.05),联合治疗组白细胞、红细胞、血小板值高于其余组(P < 0.05)。结论 热疗联合低剂量辐射对乳腺癌患者的造血及免疫功能均有较好的保护作用。

The Effect of Thermotherapy Combined with Low-dose Irradiation on Hematopoietic and Immune Function of Mammary Carcinoma

Objective To study the effect of thermotherapy combined with low- dose irradiation on hematopoietic and immune function of mammary carcinoma. Methods 40 mammary carcinoma patients were randomly divided into conventional chemotherapy group,thermotherapy group,low- dose irradiation group and combination therapy（ thermotherapy plus low-dose irradiation） group. Cyclophosphamide 100 mg / m^2 was administrated orally from day 1 to day 14,Methotrexate 40 mg / m^2,5- Fluorouracil 600 mg/m^2 were administrated intravenously on 1th and 8th day. The same dose of Methotrexate and5- Fluorouracil was qiver in low flow and maintain in the constant temperature for 120 minutes in Thermotherapy group. Mice were totally body irradiated by 0. 01 Gy / d of60Co- γ ray for 5 days per week for 3 weeks in Low- dose irradiation group. The dose and method of thermotherapy and low- dose irradiation in combined therapy group were the same as in thermotherapy group and low- dose irradiation group. Peripheral blood,including white blood cell,red blood cell and platelet,the level of interleukin 2,interleukin 4,γ interferon,CD4＋T,CD8＋T were observed after the above treatments. Results The level of interleukin 2,interleukin 4,γ interferon,CD4＋T,CD8＋T in thermotherapy group,low- dose irradiation group and combination therapy group were significantly higher than that of the conventional group. The observed index in thermotherapy group and combined group was higher than that of the low- dose irradiation group（ P ﹤ 0. 05）. Combined therapy group has a better result than the thermotherapy group,but there was no significantly difference between them（ P〉0. 05）. The counts of white blood cell,red blood cell and platelet in the combined therapy group are higher than those of other groups（ P ﹤ 0. 05）. Conclusion The combination of thermotherapy with low- dose irradiation has a better protective effect on the hematopoietic and immune function of mammary carcinoma patients.