调强适形放疗对鼻咽癌患者血清TGF-β1、IL-8和T淋巴细胞亚群水平的影响

Effect of intensity modulated radiation therapy(IMRT) on the serum levels of TGF-1,IL-8 and T-lymphocyte subsets in patients with nasopharyngeal carcinoma

目的探讨调强适形放疗(IMRT)对鼻咽癌患者血清TGF-β1、IL-8和T淋巴细胞亚群水平的影响。方法将115例鼻咽癌患者按照放疗方式分为对照组(57例)与观察组(58例),分别采用常规二维放疗与IMRT治疗。比较2组患者5年生存率及复发情况、不良反应发生情况、治疗前后血清TGF-β1、IL-8与T淋巴细胞亚群水平的变化情况。结果 1观察组患者无区域复发生存率、无瘤生存率均显著高于对照组(P<0.05),观察组患者局部复发率显著低于对照组(P<0.05),观察组患者无远处转移生存率略大于对照组(P>0.05);2对照组患者放疗过程中不良反应总发生率为40.35%(23/57),观察组为34.48%(20/58),2组不良反应发生率差异无统计学意义(P>0.05);32组患者治疗后血清TGF-β1及IL-8水平较治疗前均显著下降(P<0.05),且观察组上述指标水平下降幅度均显著大于对照组(P<0.05);42组患者治疗后CD3、CD4及CD4/CD8水平较治疗前均显著升高(P<0.05),治疗后CD8水平较治疗前均显著下降(P<0.05)。结论 IMRT对鼻咽癌的疗效显著,可能是通过改善患者血清TGF-β1、IL-8及T淋巴细胞亚群水平来实现的。

Objective To investigate the effects of intensity modulated radiation therapy （IMRT） on the serum levels of TGF-1, IL-8, and T-lymphocyte subsets in patients with nasopharyngeal carcinoma. Methods One hundred and fifteen patients with nasopharyngeal carcinoma were divided into the control group（ n = 57 ） and the observation group （n = 58 ） according to the radiation therapy, and the patients were treated with conventional two-dimensional radiotherapy and IM- RT. Comparison of two groups of patients with 5 year survival rate and recurrence, adverse reactions, the serum levels of TGF-~I, IL-8, and T lymphocyte subsets were compared before and after treatment. Results （1）patients in the observation group showed no regional recurrence survival rate and disease-free survival rate were significantly higher than those in control group （P 〈 0.05 ） , the observation group of patients with local recurrence rate was significantly lower than the con- trol group（ P 〈 0.05 ） ,observation group of patients with distant metastasis free survival rate was slightly higher than that of control group（ P 〉 0.05 ） ;（2）adverse reactions in the control group in the process of radiotherapy in patients with the to- tal incidence rate was 40.35% （23/57）, the observation group was 34.48% （20/58）, there was no significant difference in the adverse reactions between the two groups （P 〉 0.05 ） ;（3）the serum TGF-beta 1, and IL-8 levels in the two groups of patients after treatment were significantly lower than those before treatment （ P 〈 0.05 - 0.01 ） , and in the observation group, the index level decreased significantly than the control group（ P 〈 0.05 ） ;（4）the CD3, CD4 and CD4/CD8 levels in the two groups of patients after treatment were significantly higher than before treatment （ P 〈 0.05 ） , CD8 levels after and before treatment were both significantly decreased （ P 〈 0.05 ）. Conclusion The effect of IMRT on nasopharyngeal carci- noma is significant,which may be achieved by improving the level of serum TGF-131, IL-8, and T lymphocyte subsets in patients with nasopharyngeal carcinoma.