不同剂量分割模式放疗对局部晚期NSCLC患者血清EGFR、TGF-α的影响

摘要

目的:观察大分割放疗用于局部晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的治疗效果,探讨放疗前后血清EGFR、TGF-α含量的变化及临床意义.方法:回顾性选取本院放疗科2011年7月至2016年7月收治的局部晚期非小细胞肺癌患者70例,分为常规分割放疗组(处方剂量为PTV 60 Gy/30 f,单次剂量为2 Gy)和大分割放疗组(处方剂量为PTV 50 Gy/10 f,单次剂量为5 Gy),疗程结束后观察两组疗效,通过放射免疫分析和酶联法测定治疗前后患者血清中表皮生长因子受体(EGFR)和转化生长因子-α(TGF-α)的含量.结果:大分割放疗组胸部病灶治疗的有效率和稳定率分别为75.00%和85.00%,明显高于常规分割放疗组的68.00%和80.00%(P＜0.05),大分割放疗组和常规分割放疗组治疗前血清EGFR、TGF-α含量分别为(24.31 ± 4.06)μg/L、(26.30 ± 2.16)μg/L和(24.42 ± 4.04)μg/L、(25.96 ± 2.24)μg/L,两组比较无统计学差异(P＞0.05);治疗后两组血清EGFR、TGF - α含量分别为(12.11 ± 3.58)μg/L、(14.13 ± 1.72)μg/L和(14.31 ± 3.64)μg/L、(18.25 ± 1.65)μg/L,差异有统计学意义(P＜0.05).结论:大分割放 疗在不增加不良反应的情况下较常规分割放疗有更高的局控率,可能与其降低血清EGFR、TGF-α水平有关.因此,大分割放疗有望成为局部晚期非小细胞肺癌患者放疗剂量分割方式的新选择.%Objective:To observe the therapeutic effect of large dose fraction radiotherapy on locally advanced non-small cell lung cancer (NSCLC),and to explore the changes of serum levels of EGFR and TGF-α before and after radiotherapy and its clinical significance.Methods:Seventy patients with locally advanced NSCLC were selected in the Department of Radiotherapy in the hospital from July 2011 to July 2016.They were divided into conventional frac-tion radiotherapy group (prescription dose PTV 60 Gy/30 f,a single dose 2 Gy)and large dose fraction radiotherapy group (prescription dose of PTV 50 Gy /10 f,a single dose of 5 Gy).The efficacy was observed in two groups after the treatment,and the expression levels of epidermal growth factor receptor (EGFR)and transforming growth factor-α (TGF-α)of patients were analysed by radioimmunoassay and enzyme-linked assay.Results:The effective rate and stability rate of thoracic lesions in large dose fraction radiotherapy group were 75.00% and 85.00%,respective-ly,which were significantly higher than those in conventional fraction radiotherapy group (68.00% and 80.00%,P＜0.05).Hypo-fractionated radiotherapy group and conventional radiotherapy group before treatment of serum EGFR,TGF-α content was respectively (24.31 ± 4.06)μg/L,(26.30 ± 2.16)μg/L and (24.42 ± 4.04)μg/L,(25.96 ± 2.24)μg/L,the two groups had no significant difference (P＞0.05),two groups after treatment of serum EGFR,TGF-α content was respectively (12.11 ± 3.58)μg/L,(14.13 ± 1.72)μg/L and (14.31 ± 3.64)μg/L,(18.25 ± 1.65)μg/L,there were statistically significant difference (P＜0.05).Conclusion:In the large dose fraction ra-diotherapy group,there was a higher control rate than the conventional radiotherapy group without increasing the side effects,which might be associated with the down regulation of EGFR and TGF-α levels in patients＇serum.Therefore,large-segment radiotherapy is expected to be a new choice for radiation dose partitioning in patients with locally ad-vanced NSCLC.