塞来昔布配合放射治疗对脑部恶性胶质瘤的效果及免疫功能影响

Effects of celecoxib combined with radiotherapy on immune function in patients with malignant glioma of brain

目的研究塞来昔布配合放射治疗对脑部恶性胶质瘤的效果及对患者免疫功能的影响。方法脑部恶性胶质瘤患者80例,随机数字表法分对照组(n=40)和观察组(n=40)。对照组给予三维适形放射治疗,每次剂量4~6Gy,每周5次,观察组在此基础上口服塞来昔布,剂量0.2 g/次,放疗第1天开始用药,每日2次。6周后比较2组患者的近期疗效、免疫功能、血清基质金属蛋白酶-9(MMP-9)、转化生长因子β(TGF-β)和血管内皮生长因子(VEGF)水平及生活质量。结果在同步治疗6周后,观察组整体疗效和总有效率均优于对照组(P<0.05)。与治疗前比较,2组治疗后CD3^+、CD4^+比例及CD4^+/CD8^+升高,CD8^+比例降低;治疗后,观察组免疫功能指标CD3^+、CD4^+比例和CD4^+/CD8^+高于对照组,而CD8^+比例低于对照组(P<0.05)。2组患者的MMP-9、TGF-β和VEGF水平均较治疗前下降;治疗后观察组MMP-9、TGF-β和VEGF水平均低于对照组(P<0.05)。观察组生活质量优于对照组,改善总有效率高于对照组(P<0.05)。结论塞来昔布可以提高脑胶质瘤患者的放疗敏感性,联合放射治疗可以提高患者的临床疗效和生活质量,改善免疫功能,降低患者的MMP-9、TGF-β和VEGF水平。

Objective To study the clinical effect of celecoxib combined with radiotherapy in the treatment of malignant glioma tumor of brain.Methods A total of80patients diagnosed as brain malignant tumor were randomly divided into control group(n=40)and observation group(n=40).The control group received three-dimensional conformal radiotherapy for5times a week,with dosage4-6Gy each time.Base on control group,the observation group received celecoxib0.2g/time twice a day during treatment.After6weeks,the clinical efficacy,immune function,quality of life and the serum levels of metalloprotease-9(MMP-9),transforming growth factor-β(TGF-β)and vascular endothelial growth factor(VEGF)were compared between two groups of patients.Results After6weeks of the current therapy,the total effective rate was better in observation group than that of control group(P<0.05).After treatment,the levels of CD3+,CD4+and CD4+/CD8+increased in the both groups.The level of CD8+decreased,and the changes of CD3+,CD4+and CD4+/CD8+were significantly higher after treatment in the observation group than those of control group,but CD8+was lower in the observation group than that of control group(P<0.05).Meanwhile,the levels of MMP-9,TGF-βand VEGF were significantly decreased after treatment in both two groups.The levels of MMP-9,TGF-βand VEGF were significantly lower after treatment in the observation group(P<0.05).The life quality was significantly better and the overall efficiency of the improvement of the disease was higher in observation group than those of control group(P<0.05).Conclusion Celecoxib can enhance the radiosensitivity of glioma patients.The combined treatment can improve the clinical efficacy and quality of life of patients.Moreover,it improves patients’immune function and reduces the levels of VEGF,TGF-βand MMP-9.