EGFR单抗及小分子酪氨酸激酶抑制剂联合放疗对非小细胞肺癌细胞放疗敏感性的影响

Influence of EGFR Monoclonal Antibody and Small Molecule Tyrosine Kinase Inhibitor Combined with Radiotherapy on Radiosensitivity of Non-small Cell Lung Cancer Cells and the Mechanism

目的探讨表皮生长因子受体(EGFR)单抗及EGFR小分子酪氨酸激酶抑制剂(EGFR-TKI)联合放疗对非小细胞肺癌(NSCLC)细胞放疗敏感性的影响,并分析其作用机制。方法将83例非小细胞肺癌患者作为研究对象,按照随机数字表法分为对照组41和观察组42例。对照组给予EGFR-TKI联合放疗,观察组在对照组治疗基础上给予EGFR单抗治疗,比较2组治疗前后外周血T淋巴细胞亚群水平(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、血清基质金属蛋白酶-9(MMP-9)、癌胚抗原(CEA)水平,不良反应,NSCLC细胞放疗敏感性及平均无疾病进展生存时间。结果治疗8周后,对照组CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前明显下降,观察组CD4^(+)、CD4^(+)/CD8^(+)水平显著高于对照组(P<0.05)。治疗8周后,2组血清MMP-9、CEA水平均显著下降(P<0.05),且观察组血清MMP-9、CEA水平均低于对照组(P<0.05)。观察组不良反应发生率与对照组无显著差异(P>0.05),放疗敏感性、平均无疾病进展生存时间均高于对照组(P<0.05)。结论EGFR单抗与EGFR-TKI具有协同作用,联合放疗可增强NSCLC细胞放疗敏感性,提高疗效。

Objective To explore the influence of epidermal growth factor receptor(EGFR)monoclonal antibody and EGFR tyrosine kinase inhibitor(EGFR-TKI)combined with radiotherapy on radiosensitivity of non-small cell lung cancer(NSCLC)cells,and analyze the mechanism.Methods 83 patients with NSCLC were selected and divided into the control group(n=41)and the observation group(n=42)by random number table methodThe control group were treated with EGFR-TKI combined with radiotherapy.On this basis,the observation group were treated with EGFR monoclonal antibody.The levels of peripheral blood T lymphocyte subsets(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),serum matrix metalloproteinase-9(MMP-9)and carcinoembryonic antigen(CEA)before and after treatment,adverse reactions,radiosensitivity of NSCLC cells and mean progression-free survival were compared between the two groups.Results After 8 weeks of treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)in the control group were significantly reduced,and were significantly lower than those in the observation group(P<0.05).Serum MMP-9 and CEA levels were significantly decreased(P<0.05),which were lower in the observation group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions in the two groups(P>0.05),but the radiosensitivity and mean progression-free survival of the observation group were higher and longer than those of the control group(P<0.05).Conclusion EGFR monoclonal antibody and EGFR-TKI have a synergistic effect,and combined radiotherapy can enhance the radiosensitivity of NSCLC cells and improve the efficacy.