放疗和化疗对肺癌患者的总体免疫能力有不同程度的影响。

Radio- and chemotherapy variably affect the general immunocompetence of lung cancer patients.

作者信息

Vucković-Dekić L, Susnjar S, Stanojević-Bakić N, Radosavljević D

机构信息

Institute for Oncology and Radiology of Serbia, National Cancer Research Center, Beograd, Yugoslavia.

出版信息

Panminerva Med. 1999 Jun;41(2):129-33.

PMID:10479911

Abstract

OBJECTIVE

The evaluation of the effects of radiotherapy and chemotherapy on the immune status of lung cancer patients.

EXPERIMENTAL DESIGN

Prospective nonrandomized study.

SETTING

Hospitalized care.

PATIENTS

121 patients with unresectable non-small-cell lung cancer (Stage IIIb or IV), who were planned for radiotherapy (n = 81) or chemotherapy (n = 40).

MEASURES

The relative and absolute numbers of blood T lymphocytes and monocytes, as well as the mitogen-induced proliferative response of the former, and phagocyting capacity of the latter cell subpopulation, were determined in patients before starting any therapy. In radiotherapy (RT)-treated group, the immune parameters were evaluated after 45 Gy and 60 Gy had been given. In chemotherapy (ChT)-treated group, the same parameters were determined three weeks after the 2nd and 4th cycle of ChT.

RESULTS

The number and proliferative response of T lymphocytes were significantly (p < 0.001) lower, while the number and phagocyting capacity of monocytes were significantly (p < 0.001) higher in all patients before therapy, in comparison to the controls. After RT, the T cell number and proliferative response were significantly (p < 0.001) decreased, while the number of monocytes and their phagocyting capacity remained unchanged, when compared to the pretreatment values. Unlike RT, chemotherapy did not change any investigated parameter, except for the phagocyting activity of monocytes, which was significantly (p < 0.02) decreased, in comparison to the pretreatment value, after four cycles of ChT only.

CONCLUSIONS

Two cancer treatment modalities--radio- and chemotherapy--variably affect the immune status of lung cancer patients. The initial great disturbances of general immunity parameters are further aggravated by radiotherapy. Unlike RT, chemotherapy exerts no suppression at all; on the contrary, it tends to normalize some of the parameters of cellular immunity of lung cancer patients.

摘要

目的

评估放疗和化疗对肺癌患者免疫状态的影响。

实验设计

前瞻性非随机研究。

研究背景

住院治疗。

研究对象

121例无法切除的非小细胞肺癌患者（Ⅲb期或Ⅳ期），计划接受放疗（n = 81）或化疗（n = 40）。

测量指标

在开始任何治疗前，测定患者血液中T淋巴细胞和单核细胞的相对和绝对数量，以及前者的丝裂原诱导增殖反应和后者细胞亚群的吞噬能力。在放疗（RT）治疗组中，给予45 Gy和60 Gy后评估免疫参数。在化疗（ChT）治疗组中，在第2和第4周期化疗后3周测定相同参数。

结果

与对照组相比，所有患者治疗前T淋巴细胞的数量和增殖反应显著降低（p < 0.001），而单核细胞的数量和吞噬能力显著升高（p < 0.001）。放疗后，与治疗前值相比，T细胞数量和增殖反应显著降低（p < 0.001），而单核细胞数量及其吞噬能力保持不变。与放疗不同，化疗除了单核细胞的吞噬活性外，没有改变任何研究参数，仅在四个周期化疗后，与治疗前值相比，单核细胞的吞噬活性显著降低（p < 0.02）。