紫杉醇化疗同步三维适行放疗对非小细胞肺癌患者血清VEGF和MMP-9的影响

Influence of paclitaxel chemotherapy combined with concurrent three-dimensional conformal radiation therapy on serum vascular endothelial growth factor and matrix metalloproteinase-9 levels in patients with non-small cell lung cancer

目的探讨紫杉醇化疗同步三维适行放疗对非小细胞肺癌患者血清血管内皮生长因子(VEGF)和基质金属蛋白酶-9(MMP-9)的影响。方法 102例非小细胞肺癌患者随机分为3组,A组36例采用同步放化疗;B组36例采用序贯放化疗;C组30例采用单纯化疗。治疗前后测定血清VEGF和MMP-9。随访6个月,观察其临床疗效、不良反应及其对患者生活质量的影响。结果治疗后3组患者血清VEGF和MMP-9均明显降低(P<0.05或0.01),且A组比B组更低(P<0.05),B组比C组更低(P<0.05)。A组总有效率53%,B组35%,C组20%,A组总有效率显著优于B组(P<0.05),B组显著优于C组(P<0.05);3组患者贫血、白细胞减少、血小板减少、神经毒性、肝功能损害、肾功能损害、恶心、呕吐的发生率比较无显著性差异(P均>0.05);A组生活质量好转率为50%,B组33%,C组17%,A组好转率显著优于B组(P<0.05),B组好转率显著优于C组(P<0.05)。结论紫杉醇化疗同步三维适行放疗可以明显减少非小细胞肺癌患者血清VEGF和MMP-9的表达,且临床疗效显著,不良反应少,患者生活质量明显好转。

Objective It is to approach the influence of paclitaxel chemotherapy combined with concurrent three-dimensional conformal radiation therapy on serum vascular endothelial growth factor （VEGF） and matrix metalloproteinase - 9 （MMP- 9） levels in patients with non-small cell lung cancer （NSCLC）. Methods 102 patients with NSCLC were randomly divided into three group： 36 cases in group A were treated with paclitaxel chemotherapy plus concurrent three-dimensional conformal radiation therapy, 36 cases in group B were treated with paclitaxel chemotherapy plus sequential therapy of three - dimensional conformal radiotherapy, and 30 cases in group C were treated with paclitaxel chemotherapy. The serum VEGF and MMP- 9 levels were detected before and after treatment. With a follow-up of 6 months, clinical efficacy, adverse reactions and quality of life associated with the treatment were evaluated. Results The serum VEGF and MMP - 9 levels in three groups were Significantly decreased after treatment with the order of group A 〈 group B 〈 group C （ P 〈 0. 05 or 0.01 ）. The total ef- fective rate was 53% in group A, 35% in group B and 20% in group C, the total effective rate in group A was significantly better than group B （ P 〈 0.05） and group B was significantly better than group C （ P 〈 0.05 ）. There was no significant difference in the incidence of anemia, leukopenia, thrombocytopenia, neurotoxicity, liver damage, kidney damage, nausea and vomiting among three groups （ all P 〉 0.05）. The improvement rate of life quality was 50% in group A, 33% in group B and 17% in group C, the data in group A was significantly increased compared with group B （P 〈0.05） , and in group B was significantly increased compared with group C （ P 〈 0.05）. Conclusion Paclitaxel chemotherapy plus concurrent three-dimensional conformal radiation therapy significantly decreased serum VEGF and MMP- 9 levels in patients with NSCLC.