rhGM⁃CSF预防非小细胞肺癌放疗所致急性放射性食管炎的效果观察

Observation on the effects of rhGM⁃CSF in prevention of acute radiotherapy⁃induced esophagitis in treatment of NSCLC

目的探讨注射用重组人粒细胞⁃巨噬细胞集落刺激因子(rhGM⁃CSF)预防非小细胞肺癌(NSCLC)放疗所致急性放射性食管炎的效果。方法选取2016年6月至2020年10月医院收治的168例拟接受放疗的NSCLC患者为研究对象,以随机数字表法分为对照组(n=84)和研究组(n=84)。对照组采用三维适形放疗联合化疗进行治疗,研究组在对照组的基础上采用rhGM⁃CSF治疗,2组均治疗2~6个周期。比较2组治疗前后免疫功能、生活质量核心问卷(QLQ⁃C30)评分,比较2组治疗后放射性食管炎发生情况以及放射性食管炎视觉模拟量表(VAS)评分。结果治疗后,2组CD4+、CD3+、CD16+CD56+水平均升高(P<0.05),研究组高于对照组(P<0.05);治疗后,2组放射性食管炎分级等级差异有统计学意义(P<0.05),且研究组3~4级放射性食管炎发生率低于对照组(P<0.05);2组放射性食管炎患者VAS评分均降低(P<0.05),研究组放射性食管炎患者VAS评分低于对照组(P<0.05);2组QLQ⁃C30评分均降低(P<0.05),研究组低于对照组(P<0.05)。结论rhGM⁃CSF联合三维适形放疗用于治疗NSCLC患者,可改善患者的免疫功能,提高患者的生活质量,减少3~4级放射性食管炎发生率,减轻NSCLC患者经三维适形放疗所致放射性食管炎患者疼痛。

Objective To investigate the effects of recombinant human granulocyte⁃macrophage colony stimulating factor(rhGM⁃CSF)for injection for prevention of acute radiotherapy⁃induced esophagitis in treatment of non⁃small cell lung cancer(NSCLC).Methods A total of 168 patients with NSCLC who were admitted to the hospital from June 2016 to October 2020 and who were to receive radiotherapy were selected as research subjects,and were randomly and equally divided into the control group(n=84)and the study group(n=84).The control group was treated with three⁃dimensional conformal radiotherapy combined with chemotherapy,while the study group was treated with rhGM⁃CSF on the basis of the control group.Both groups were all treated for 2⁃6 cycles.The immune function and life quality questionnaire(QLQ⁃C30)scores of the two groups were compared before and after treatment,and the incidence of radiation⁃induced esophagitis and the visual analog scale(VAS)scores of radiation⁃induced esophagitis were compared after treatment between the two groups.Results After treatment,the levels of CD4+,CD3+,CD16+CD56+in the two groups all increased(P<0.05),with those of the study group being higher(P<0.05).Following treatment,there were significant differences in the grades of radiation⁃induced esophagitis,with the incidence of grade 3 to 4 radiation⁃induced esophagitis in the study group being lower than that in the control group,when comparisons were made between the two groups(P<0.05).The VAS scores of radiation⁃induced esophagitis in the two groups all decreased(P<0.05),with those of the patients in the former being lower than those in the latter(P<0.05).The QLQ⁃C30 scores in the two groups all decreased(P<0.05),with those of the former being much lower(P<0.05).Conclusion rhGM⁃CSF combined with three⁃dimensional conformal radiotherapy in treatment of the patients with NSCLC could enhance the immune function,life quality,reduce the incidence of grade 3 to 4 radiation⁃induced esophagitis and relieve pain in the NSCLC patients with radiation⁃induced esophagitis caused by three⁃dimensional conformal radiotherapy.