同步放化疗联合甘氨双唑钠治疗NSCLC的疗效及对microRNA-21与SIRT1表达的影响

Influence of synchronization radiochemotherapy combined with glycididazole sodium on clinical effects and expressions of microRNA-21 and SIRT1 in patients with refractory non-small cell lung cancer

目的研究同步放化疗联合甘氨双唑钠(希美纳)治疗难治性非小细胞肺癌(NSCLC)的临床疗效及对microRNA-21与SIRT1表达的影响。方法 87例难治性NSCLC患者随机分为研究组(n=46)和对照组(n=41)。对照组接受同步放化疗,研究组患者接受同步放化疗联合希美纳治疗。放疗采用调强放疗技术,化疗采用顺铂+依托泊苷方案。研究组在放化疗的同期隔天给予希美纳800 mg/m2,直至放疗结束。观察2组患者的临床疗效、不良反应及预后情况。采用荧光定量PCR法测定microRNA-21相对表达量,免疫组化染色法测定SIRT1蛋白的表达。结果研究组治疗总有效率显著高于对照组(P<0.05)。经治疗后,2组microRNA-21和SIRT1的表达水平显著降低(P<0.05),且研究组microRNA-21和SIRT1的表达水平显著低于对照组(P<0.05)。研究组生存时间显著高于对照组(P<0.05),且1年生存率显著高于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论单纯同步放化疗联用希美纳可以显著改善难治性NSCLC患者的临床症状,降低microRNA-21与SIRT1的表达,且并不增加不良反应的发生风险,同时可以提高患者的1年生存率,延长中位生存期,值得临床推广应用。

Objective To investigate the effects of synchronization radiochemotherapy combined with glycididazole sodium on curative effects and expressions of microRNA-21 and SIRT1 in patients with refractory non-small cell lung cancer(NSCLC).Methods Eighty-seven patients with refractory NSCLC were randomly divided into two observation group(n=46)and control group(n=41).The patients in control group were treated by synchronization radiochemotherapy,with intensity modulated radiation therapy+chemotherapy(cisplatin plus etoposide),however,the patients in observation group,on the basis of control group,were treated by glycididazole sodium(800mg/m 2),until the end of radiotherapy.The clinical curative effects,adverse reactions and prognosis were observed,moreover,the expression levels of microRNA-21 and SIRT1 protein were detected by fluorescent quantitation PCR and immunohistochemisty staining,respectively.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).After treatment,the expression levels of microRNA-21 and SIRT1were obviously decreased in both groups(P<0.05),moreover,the expression levels of microRNA-21 and SIRT1 in observation group were significantly lower than those in control group(P<0.05).The survival time of patients in observation group was significantly longer than that in control group(P<0.05),moreover,the 1-year survival rate in observation group was significantly higher than that in control group(P<0.05).Besides there were no significant differences in the incidence rates of adverse reactions between two groups(P>0.05).Conclusion The synchronization radiochemotherapy combined with glycididazole sodium can obviously improve the clinical symptoms of patients with NSCLC,meanwhile,which can decrease the expression levels of microRNA-21 and SIRT1,without increasing the risk of adverse reaction occurrence,moreover,which can increase 1-year survival rate and lengthen median survival time of patients,therefor,which is worth using widely in clinical practice.