沙利度胺辅助调强放化疗对NSCLC患者预后的影响

To investigate the effect of thalidomide adjuvant intensity-modulated chemoradiotherapy on the prognosis of patients with non-small cell lung cancer

目的探讨沙利度胺辅助调强放化疗对非小细胞肺癌(NSCLC)患者预后的影响。方法选取2020年2月至2021年3月收治的NSCLC患者104例,随机分为对照组和观察组,每组52例。对照组采用调强放化疗,观察组采取沙利度胺辅助调强放化疗。观察2组临床疗效、预后情况、治疗前后肿瘤标志物[糖类抗原-125(CA125)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)]、血管新生指标[碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)、血管内皮生长因子-C(VEGF-C)]、微小核糖核酸-215(miR-215)、微小核糖核酸-34a(miR-34a)及肿瘤特异性生长因子(TSGF)、细胞增殖抗原(PCNA)、可溶性E-钙黏蛋白(SE-CAD)等血清因子表达。结果观察组疾病控制率71.15%与对照组55.77%比较,差异无统计学意义(P>0.05)。观察组治疗1、3个月后血清CA125、CEA、CYFRA21-1水平低于对照组(P<0.05)。观察组治疗1、3个月后血清bFGF、VEGF、VEGF-C水平低于对照组(P<0.05)。观察组治疗1、3个月后miR-34a高于对照组,miR-215低于对照组(P<0.05)。观察组治疗1、3个月后血清PCNA、TSGF、SE-CAD水平低于对照组(P<0.05)。观察组无进展生存期、总生存期及总生存率大于对照组(P<0.05)。结论沙利度胺辅助调强放化疗可降低NSCLC患者肿瘤标志物水平,延长生存期,这可能与血管新生抑制、肿瘤分子及微小miR调控有关。

Objective To investigate the effect of adjuvant thalidomide combined with intensively-modulated chemoradiotherapy on prognosis of patients with non-small cell lung cancer(NSCLC).Methods A total of 104 patients with NSCLC in our hospital from February 2020 to March 2021 were randomly divided into control group(n=52)and observation group(n=52).All patients received intensively-modulated chemoradiotherapy,and those in the observation group additionally received adjuvant thalidomide.The clinical efficacy,prognosis,tumor markers(carbohydrate antigen-125[CA125],carcinoembryonic antigen[CEA],cytokeratin 19 fragment[CYFRA21-1]),and angiogenesis indicators(basic fibroblast growth factor[bFGF],vascular endothelial growth factor[VEGF],and vascular endothelial growth factor-C[VEGF-C])before and after treatment were observed between groups.The expression of microRNA-215(miR-215),microRNA-34a(miR-34a),tumor specific growth factor(TSGF),proliferating cell nuclear antigen(PCNA),soluble E-cadherin(sE-cad)and other serum factors were assessed.Results The disease control rate of the observation group was comparable to that of the control group(71.15%vs 55.77%,P>0.05).After treatment,the 1-month and 3-month serum levels of CA125,CEA and CYFRA21-1 in the observation group were significantly lower than those of control group(P<0.05).The 1-month and 3-month serum levels of bFGF,VEGF and VEGF-C in the observation group were significantly lower than those of the control group(P<0.05).The 1-month and 3-month serum levels of miR-34a in the observation group were significantly higher than those of the control group,and the levels of miR-215 were significantly lower(P<0.05).The 1-month and 3-month serum levels of PCNA,TSGF and sE-Cad in the observation group were significantly lower than those of the control group(P<0.05).The progression-free survival,overall survival and overall survival rates in the observation group were significantly increased than those of the control group(P<0.05).Conclusion Adjuvant thalidomide combined with intensity-modulated chemoradiotherapy can reduce the level of tumor markers and prolong the survival of NSCLC patients by inhibiting the expression of angiogenesis indicators,tumor molecules,and micro ribonucleic acid.