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目的探讨康莱特对局部晚期非小细胞肺癌(LA-NSCLC)同步放化疗的影响。方法选取2012年1月至2015年1月间承德医学院附属医院收治的60例LA-NSCLC患者,采用随机数表法分为观察组和对照组,每组30例。观察组患者在放疗联合顺铂和依托泊苷化疗基础上给予康莱特注射液治疗,对照组患者给予常规放疗联合顺铂和依托泊苷化疗,比较两组患者治疗前1d、末次治疗次日及治疗后4周的T淋巴细胞亚群和免疫球蛋白相关指标水平变化,观察两组患者的不良反应,治疗后4周对患者临床受益反应程度进行评价。结果观察组患者均顺利完成治疗,对照组有3例患者出现严重不良反应无法耐受而终止治疗。两组患者总有效率、肿瘤控制率及临床受益率比较,差异均无统计学意义(均P>0.05)。与治疗前比较,放化疗后4周时,观察组患者CD3~+、CD4~+及CD4~+/CD8~+比值升高,CD8~+降低,对照组患者CD4~+及CD4~+/CD8~+比值升高,且观察组患者CD3~+、CD4~+及CD4~+/CD8~+比值均高于对照组患者,差异均有统计学意义(均P<0.05)。放化疗后4周,观察组患者Ig A和Ig M水平均高于对照组患者,差异均有统计学意义(均P<0.05)。治疗过程中,观察组患者严重不良反应总发生率低于对照组患者,差异有统计学意义(P<0.05)。结论康莱特注射液联合常规放化疗治疗LA-NSCLC,可提高近期疗效及临床收益率,减轻短期内免疫抑制状态,促进机体细胞及体液免疫功能恢复,减轻不良反应,利于放化疗顺利进行,值得临床推广。
Objective To investigate the effect of Kanglaite on concurrent chemoradiotherapy in locally advanced non-small cell lung cancer (LA-NSCLC). Methods Sixty LA-NSCLC patients admitted to Chengde Medical College Hospital from January 2012 to January 2015 were randomly divided into observation group (n = 30) and control group (n = 30). Patients in the observation group were treated with Kanglaite Injection on the basis of radiotherapy combined with cisplatin and etoposide chemotherapy. Patients in the control group were given conventional radiotherapy combined with cisplatin and etoposide chemotherapy. The patients in the two groups were compared on the 1st day before treatment and on the next day after the last treatment The T lymphocyte subsets and immunoglobulin-related indexes were observed at 4 weeks after treatment. Adverse reactions were observed in both groups. The clinical benefit response was assessed 4 weeks after treatment. Results All the patients in the observation group were successfully treated. In the control group, 3 patients were unable to tolerate serious adverse reactions and the treatment was terminated. There was no significant difference between the two groups in total effective rate, tumor control rate and clinical benefit rate (all P> 0.05). Compared with those before treatment, the ratio of CD3 ~ +, CD4 ~ + and CD4 ~ + / CD8 ~ + increased and CD8 ~ + decreased in control group at 4 weeks after radiotherapy and chemotherapy. CD4 ~ + and CD4 ~ + / CD8 ~ + ratio increased, and the ratio of CD3 ~ +, CD4 ~ + and CD4 ~ + / CD8 ~ + in the observation group was higher than that in the control group, the difference was statistically significant (all P <0.05). Four weeks after radiotherapy and chemotherapy, IgA and IgM levels in the observation group were significantly higher than those in the control group (all P <0.05). During the treatment, the total incidence of serious adverse reactions in the observation group was lower than that in the control group, the difference was statistically significant (P <0.05). Conclusions Kanglaite injection combined with conventional radiotherapy and chemotherapy in the treatment of LA-NSCLC can improve the short-term curative effect and clinical rate of return, shorten the immunosuppressive state in the short term, promote the recovery of cellular and humoral immune function, reduce the adverse reactions and facilitate the successful radiotherapy and chemotherapy, which is worth Clinical promotion.