肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2014年
9期
620-623
,共4页
王轶楠%赵郁%岳海淑%尹晶瑜
王軼楠%趙鬱%嶽海淑%尹晶瑜
왕질남%조욱%악해숙%윤정유
癌,非小细胞肺%同期放化疗%序贯放化疗%基质金属蛋白酶2%转化生长因子β1
癌,非小細胞肺%同期放化療%序貫放化療%基質金屬蛋白酶2%轉化生長因子β1
암,비소세포폐%동기방화료%서관방화료%기질금속단백매2%전화생장인자β1
Carcinoma,non-small-cell lung%Concurrent chemoradiotherapy%Sequential therapy%Matrix metalloproteinase 2%Transforming growth factor β1
目的 比较同期放化疗和放化序贯治疗对局部晚期非小细胞肺癌外周血基质金属蛋白酶2(MMP-2)、转化生长因子β1(TGF-β1)的影响.方法 2010年1月至2012年12月64例经病理确诊的ⅡB至ⅢB期的非小细胞肺癌患者通过抽签方法被随机分成放化同期治疗组(A组)和放化序贯治疗组(B组),每组32例患者,A组采用三维适形放疗及同期EP或TC方案化疗,B组接受三维适形放疗后序贯EP或TC方案化疗.在放疗前、后和完成放化疗后采用酶联免疫吸附法(ELISA)法检测MMP-2和TGF-β 1水平,比较两组MMP-2和TGF-β1动态变化情况.结果 A、B两组缓解率分别为90.6％(29/32)和68.8％(22/32)(x2=4.730 0,P=0.029 6);中位肿瘤进展时间(TTP)分别为9.1、8.2个月,差异无统计学意义(P=0.100 3);中位生存时间分别为17.8、15.9个月,1年OS率分别为65.05％、60.24％,2年OS率分别为49.45％、43.07％,两组之间总生存率差异有统计学意义(P=0.048 0).在放疗前,A组和B组的MMP-2分别为(276.5±98.2) μg/ml和(263.9±103.5) μg/ml,差异无统计学意义(t=0.499 6,P=0.619 1),放疗后分别为(242.1±53.2) μg/ml和(298.7±68.4) μg/ml,差异有统计学意义(t=3.694 9,P=0.005 0),治疗结束后分别为(60.5±24.4) μg/ml和(75.2±30.7) μg/ml,差异有统计学意义(t=2.120 5,P=0.038 0);治疗前,TGF-β1分别为(1 624.3±454.2)ng/ml和(1 564.9±517.8)ng/ml,差异无统计学意义(t=0.208 6,P=0.835 4),放疗后分别为(1 383.5±469.3) ng/ml和(1 785.3±412.6)ng/ml,差异有统计学意义(t=3.637 3,P=0.006 0),治疗结束后分别为(610.5±215.4)ng/ml和(750.3±263.7) ng/ml,差异有统计学意义(t=2.322 6,P=0.023 5).结论 同期放化疗能够有效拮抗放射诱导的局部晚期肺癌外周血MMP-2和TGF-β1的升高.
目的 比較同期放化療和放化序貫治療對跼部晚期非小細胞肺癌外週血基質金屬蛋白酶2(MMP-2)、轉化生長因子β1(TGF-β1)的影響.方法 2010年1月至2012年12月64例經病理確診的ⅡB至ⅢB期的非小細胞肺癌患者通過抽籤方法被隨機分成放化同期治療組(A組)和放化序貫治療組(B組),每組32例患者,A組採用三維適形放療及同期EP或TC方案化療,B組接受三維適形放療後序貫EP或TC方案化療.在放療前、後和完成放化療後採用酶聯免疫吸附法(ELISA)法檢測MMP-2和TGF-β 1水平,比較兩組MMP-2和TGF-β1動態變化情況.結果 A、B兩組緩解率分彆為90.6％(29/32)和68.8％(22/32)(x2=4.730 0,P=0.029 6);中位腫瘤進展時間(TTP)分彆為9.1、8.2箇月,差異無統計學意義(P=0.100 3);中位生存時間分彆為17.8、15.9箇月,1年OS率分彆為65.05％、60.24％,2年OS率分彆為49.45％、43.07％,兩組之間總生存率差異有統計學意義(P=0.048 0).在放療前,A組和B組的MMP-2分彆為(276.5±98.2) μg/ml和(263.9±103.5) μg/ml,差異無統計學意義(t=0.499 6,P=0.619 1),放療後分彆為(242.1±53.2) μg/ml和(298.7±68.4) μg/ml,差異有統計學意義(t=3.694 9,P=0.005 0),治療結束後分彆為(60.5±24.4) μg/ml和(75.2±30.7) μg/ml,差異有統計學意義(t=2.120 5,P=0.038 0);治療前,TGF-β1分彆為(1 624.3±454.2)ng/ml和(1 564.9±517.8)ng/ml,差異無統計學意義(t=0.208 6,P=0.835 4),放療後分彆為(1 383.5±469.3) ng/ml和(1 785.3±412.6)ng/ml,差異有統計學意義(t=3.637 3,P=0.006 0),治療結束後分彆為(610.5±215.4)ng/ml和(750.3±263.7) ng/ml,差異有統計學意義(t=2.322 6,P=0.023 5).結論 同期放化療能夠有效拮抗放射誘導的跼部晚期肺癌外週血MMP-2和TGF-β1的升高.
목적 비교동기방화료화방화서관치료대국부만기비소세포폐암외주혈기질금속단백매2(MMP-2)、전화생장인자β1(TGF-β1)적영향.방법 2010년1월지2012년12월64례경병리학진적ⅡB지ⅢB기적비소세포폐암환자통과추첨방법피수궤분성방화동기치료조(A조)화방화서관치료조(B조),매조32례환자,A조채용삼유괄형방료급동기EP혹TC방안화료,B조접수삼유괄형방료후서관EP혹TC방안화료.재방료전、후화완성방화료후채용매련면역흡부법(ELISA)법검측MMP-2화TGF-β 1수평,비교량조MMP-2화TGF-β1동태변화정황.결과 A、B량조완해솔분별위90.6％(29/32)화68.8％(22/32)(x2=4.730 0,P=0.029 6);중위종류진전시간(TTP)분별위9.1、8.2개월,차이무통계학의의(P=0.100 3);중위생존시간분별위17.8、15.9개월,1년OS솔분별위65.05％、60.24％,2년OS솔분별위49.45％、43.07％,량조지간총생존솔차이유통계학의의(P=0.048 0).재방료전,A조화B조적MMP-2분별위(276.5±98.2) μg/ml화(263.9±103.5) μg/ml,차이무통계학의의(t=0.499 6,P=0.619 1),방료후분별위(242.1±53.2) μg/ml화(298.7±68.4) μg/ml,차이유통계학의의(t=3.694 9,P=0.005 0),치료결속후분별위(60.5±24.4) μg/ml화(75.2±30.7) μg/ml,차이유통계학의의(t=2.120 5,P=0.038 0);치료전,TGF-β1분별위(1 624.3±454.2)ng/ml화(1 564.9±517.8)ng/ml,차이무통계학의의(t=0.208 6,P=0.835 4),방료후분별위(1 383.5±469.3) ng/ml화(1 785.3±412.6)ng/ml,차이유통계학의의(t=3.637 3,P=0.006 0),치료결속후분별위(610.5±215.4)ng/ml화(750.3±263.7) ng/ml,차이유통계학의의(t=2.322 6,P=0.023 5).결론 동기방화료능구유효길항방사유도적국부만기폐암외주혈MMP-2화TGF-β1적승고.
Objective To compare concurrent chemoradiotherapy and sequential therapy effect on serum MMP-2 and TGF-β1 in local advanced non-small cell lung cancer (NSCLC).Methods From 2010 January to 2012 December,64 Ⅱ B and Ⅲ B stage patients with pathologically confirmed NSCLC were randomly divided into concurrent chemoradiotherapy group (group A) and sequential therapy group (group B).Each group had 32 patients.Group A was treated with three-dimensional conformal radiotherapy and concurrent chemotherapy with TC or EP.Group B received TC or EP regimen chemotherapy after three-dimensional conformal radiotherapy.Serum MMP-2 and TGF-β1 on those patients from preradiotherapy,radiotherapy in one month to post-treatment were measured by enzyme-linked immunoabsorbent assay.The dynamic changes of MMP-2 and TGF-β1 were compared.Results The remission rates in groups A and B were 90.6 ％ and 68.8 ％,the effective rate of treatment in group A was better than that of group B (x2 =4.730 0,P =0.029 6).The long-term effect analyzed with Kaplan-Meier method,the median time to tumor progression (TTP) were 9.1 months and 8.2 months,there was no statistically significant difference (P =0.100 3).The overall survival rates between two groups after the Log-rank test had significant difference (P =0.048),the median survival time (MST) were 17.8 and 15.9 months,1 year OS rates were 65.05 ％ and 60.24 ％,2 years OS rates were 49.45 ％ and 43.07 ％.The MMP-2 level of A group and B were (276.5±98.2) μg/ml and (263.9±103.5) μg/ml,there was no significant difference (t =0.499 6,P =0.619 1) before radiotherapy,they were (242.1±53.2) μg/ml and (298.7±68.4) μg/ml after radiotherapy,there was significant difference (t =3.694 9,P =0.005) and after treatment were (60.5 ±24.4) μg/ml and (75.2±30.7) μg/ml,there was significant difference (t =2.120 5,P =0.038 0).The TGF-β1 level of A group and B were (1 624.3±454.2) ng/ml and (1 564.9±517.8) ng/ml,there was no significant difference (t =0.208 6,P =0.835 4) before radiotherapy,they were (1 383.5±469.3) ng/ml and (1 785.3±412.6) mg/ml after radiotherapy,there was significant difference (t =3.637 3,P =0.006 0) and after treatment were (610.5±215.4) ng/ml and (750.3±263.7) ng/ml,there was significant difference (t =2.322 6,P =0.023 5).Conclusions Concurrent chemoradiotherapy could effectively antagonize radiation-induced MMP-2 and TGF-β1 expression increased in locally advanced NSCLC.This study suggests that the concurrent chemoradiotherapy can inhibit abilities of tumor invasion and metastasis through decreasing the MMP-2 and TGF-β1 levels.
