Abstract:
Objective To investigate the radiosensitization effect of endostatin combined with intensity-modulated radiotherapy in elderly patients with advanced non-small cell lung cancer (NSCLC) and its effect on T cells and natural killer (NK) cells.
Methods A total of 106 patients with NSCLC in our hospital from March 2015 to August 2016 were selected and divided into a study group and a control group according to a simple random number table method, 53 cases in each group. The control group took intensity-modulated radiotherapy, and the study group took endostatin on the basis of the control group. The clinical efficacy, levels of NK cells and T cells, serum tumor marker levels, erythropoieth (EPO) mRNA, EPO-receptor mRNA levels before and after treatment, toxic and side effects were counted in the two groups. After 3 years of follow-up, the survival [median overall survival (OS) , median progression-free survival (PFS) ]of the two groups was counted.
Results The tumor control rate of the study group (86.79﹪) was higher than that of the control group (69.81﹪) (P < 0.05) ; after treatment, the NK cells, CD3+, CD4+, CD4+/CD8+ in the two groups were lower than before treatment, and CD8+ was higher than before treatment. However, NK cells (10.44±2.13) ﹪, CD3+ (59.33±5.15) ﹪, CD4+ (36.40±3.86) ﹪, and CD4+/CD8+ (1.23±0.30) in the study group were higher than those in the control group, CD8+ (29.56±2.50) ﹪ was lower than the control group (P < 0.05) ; after treatment, the serum levels of CA199, CA125, CEA and CY211 in the two groups were lower than before treatment. And the CA199 (30.15±4.14) kU/L, CA125 (29.77±5.30) kU/ L, CEA (17.97±4.10) μg/L, CY211 (4.56±1.34) μg/L of the study group were lower than those of the control group (P < 0.05) ; after treatment, the levels of EPO mRNA and EPO-R mRNA in the two groups were lower than before treatment. EPO mRNA (0.80±0.06) and EPO-R mRNA (0.81±0.08) in the study group were lower than those in the control group (P < 0.05) ; the incidence of hemoglobin reduction, liver and kidney function damage, vomiting and nausea, neutropenia between the study group and the control group were not significantly different (P > 0.05) ; the median PFS of 8 months and the median OS of 23 months in the study group were higher than those in the control group (P < 0.05) .
Conclusion Combined intensity-modulated radiotherapy and endostatin for the treatment of middle-late advanced NSCLC in the elderly can effectively improve the tumor control rate and the survival status of patients, which may be because it can reduce the level of serum tumor markers, reduce the impact on immune function, regulate EPO mRNA and EPO-R mRNA, and have safety.
Key words:
Endostatin,
Intensity-modulated radiotherapy,
NSCLC,
T cells,
NK cells
Na Yang, Yi Sun, Nijiati Dilinuner·. Exploration of the clinical value of endostatin combined with intensity-modulated radiotherapy in elderly patients with advanced non-small cell lung cancer[J]. Chinese Journal of Cell and Stem Cell(Electronic Edition), 2021, 11(01): 34-39.