同步放化疗联合复方苦参注射液用于鼻咽癌的近期疗效及对免疫因子、MIP-3α和sCD44水平的影响

Short-Term Efficacy of Concurrent Radiochemotherapy Combined with Compound Kushen Injection in the Treatment of Nasopharyngeal Carcinoma and Its Effects on Immune Factor,MIP-3αand sCD44 Levels

目的:探讨同步放化疗联合复方苦参注射液用于鼻咽癌的近期疗效及对免疫因子、巨噬细胞炎性蛋白-3α(MIP-3α)和可溶性标准CD44(sCD44)水平的影响。方法:选择2019年3月至2022年3月该院收治的鼻咽癌患者60例,采用随机数字表法按1∶1比例随机分为观察组(n=30)与对照组(n=30)。对照组患者采用同步放化疗治疗,观察组患者在同步放化疗的基础上联合应用复方苦参注射液。两组患者均以21 d为1个周期,连续治疗3个周期。比较两组患者的近期疗效、不良反应,治疗前后卡诺夫斯凯计分(KPS)、Th1细胞因子、Th2细胞因子、血清MIP-3α和sCD44水平变化。结果:观察组鼻咽癌患者的总有效率为70.00%(21/30),高于对照组的43.33%(13/30),差异有统计学意义(P<0.05)。两组鼻咽癌患者治疗后的KPS评分高于治疗前,观察组鼻咽癌患者治疗后的KPS评分高于对照组,差异均有统计学意义(P<0.05)。两组鼻咽癌患者治疗后的血清肿瘤坏死因子α(TNF-α)、γ干扰素(IFN-γ)水平低于治疗前,而白细胞介素(IL)2水平高于治疗前;观察组鼻咽癌患者治疗后的血清TNF-α、IFN-γ水平低于对照组,而IL-2水平高于对照组,差异均有统计学意义(P<0.05)。两组鼻咽癌患者治疗后的血清IL-4、IL-6和IL-10水平低于治疗前,且观察组患者低于对照组,差异均有统计学意义(P<0.05)。两组鼻咽癌患者治疗后的血清MIP-3α、sCD44水平低于治疗前,且观察组患者低于对照组,差异均有统计学意义(P<0.05)。观察组鼻咽癌患者肝肾功能异常、骨髓抑制、胃肠道反应和乏力的发生率均低于对照组,差异均有统计学意义(P<0.05)。结论:同步放化疗联合复方苦参注射治疗鼻咽癌的近期疗效良好,可调节免疫因子水平,降低血清MIP-3α和sCD44水平,且不良反应少。

OBJECTIVE:To probe into the short-term efficacy of concurrent radiochemotherapy combined with compound Kushen injection in the treatment of nasopharyngeal carcinoma(NPC),and its effects on immune factor,macrophage inflammatory protein-3α(MIP-3α)and soluble standard form CD44(sCD44)levels.METHODS:Totally 60 patients with NPC admitted into the hospital from Mar.2019 to Mar.2022 were selected to be divided into the observation group(n=30)and control group(n=30)according to the ratio of 1∶1 via the random number table method.The control group was treated given concurrent radiochemotherapy,while the observation group was given compound Kushen injection on the basis of concurrent radiochemotherapy.Both groups were treated for 3 consecutive cycles with 21 d as a cycle.The short-term efficacy and adverse drug reactions,the Karnofsky performance(KPS)score,Th1 cytokine,Th2 cytokine,serum MIP-3αand sCD44 levels before and after treatment were compared between two groups.RESULTS:The total effective rate of NPC patients in the observation group was 70.00%(21/30),which was higher than that of the control group 43.33%(13/30),with statistically significant difference(P<0.05).The KPS scores of NPC patients in both groups after treatment were higher than those before treatment,and the KPS scores of NPC patients in the observation group were higher than those in the control group after treatment,with statistically significant differences(P<0.05).The serum tumor necrosis factorα(TNF-α)andγinterferon(IFN-γ)levels of NPC patients in both groups were lower after treatment than those before treatment,while the interleukin(IL)2 levels of NPC patients in both groups were higher after treatment than those before treatment;the serum TNF-αand IFN-γlevels of NPC patients in the observation groups were lower than those in the control group,while the IL-2 levels of NPC patients in the observation groups were higher than those in the control group,with statistically significant differences(P<0.05).The serum IL-4,IL-6 and IL-10 levels of NPC patients in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The serum MIP-3αand sCD44 levels of NPC patients in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The incidences of abnormal hepatorenal function,bone marrow suppression,gastrointestinal reactions and weakness in NPC patients in the observation group were lower than those the control group,with statistically significant differences(P<0.05).CONCLUSIONS:The concurrent radiochemotherapy combined with compound Kushen injection in the treatment of nasopharyngeal carcinoma has a good short-term efficacy,which can regulate the immune factor level,reduce serum MIP-3αAnd sCD44 levels,with less adverse reactions.