注射用黄芪多糖联合三维适形放疗治疗老年肺癌临床观察

目的:观察注射用黄芪多糖(APS)联合三维适形放射治疗(3D-CRT)对老年非小细胞肺癌的疗效.方法:将80例确诊的Ⅰ～Ⅳ期老年非小细胞肺癌患者,随机分为中药联合放疗治疗(治疗组,40例)和单纯放疗治疗(对照组,40例).放疗采用三维适形放射治疗,治疗总剂量50～70Gy,2Cy/次,每日1次,每周5次.中药选用注射用黄芪多糖250mg加入5%葡萄糖或生理盐水500ml中静滴,放疗当日开始给药,每天1次,直至放疗结束后停药,疗程与放疗同步.比较两组的近期疗效、外周血象、免疫功能及生活质量.结果:治疗组近期有效率87.5%,对照组有效率72.5%,两组间比较无明显差异(P＞0.05).治疗组患者的外周血白细胞计数治疗后下降不明显、而对照组下降明显,治疗组治疗前后比较无显著性差异,而对照组治疗前后比较有显著性差异(P＜0.05),对照组治疗后白细胞数较治疗组有显著性差异(P＜0.05);治疗组患者治疗后T淋巴细胞亚群CD8、CD4/CD8较治疗前好转,差异显著(P＜O.05),对照组放疗前后比较差异无显著性(P＞0.05),两组间治疗后差异有显著性(P＜0.05).结论:注射用黄芪多糖联合3D-CRT可以降低老年非小细胞肺癌患者的放射副反应,提高机体免疫水平.

Effect of Astragalus Polysaccharide in Combination with Three-dimensional Conformal Radiotherapy on Elderly Patients with Non-small Cell Lung Cancer

Objective: To observe the therapeutic efficacy of astragalus polysaccharide (APS) in combination with three-dimensional conformal radiotherapy (3D-CRT) for elderly patients with non-small cell lung cancer (NSCLC). Methods: A total of 80 elderly patients with I～IV stage NSCLC were randomly divided into two groups. The 40 patients in the therapeutic group received radiotherapy in combination with APS. The 40 patients in the control group received radiotherapy alone. Both groups received 3D-CRT with a total dose of 50～ 70Gy, 2.0Gy/fraction, once a day, 5 times per week. The patients in the therapeutic group were treated with radiotherapy combined with injection of APS (250mg in 5% glucose) or normal saline (500 mL) intravenously once a day until the end of radiotherapy. The short-term efficacy and patients' quality of life were evaluated. The T-lymphocyte subpopulation and peripheral blood leukocyte count were also measured after treatment. Results: The short-term effective rates of the therapeutic group and the control group were 87.5% and 72.5%, respectively, without significant difference between the two groups (P＞0.05). The decrease of peripheral blood leukocyte count after treatment in the control group was significant (P＜0.05). In the therapeutic group, the T-lymphocyte subsets CD8 and CD4/CD8 were improved after treatment, with a significant difference (P＜ 0.05). But in the control group, no significant changes in T-lymphocyte subsets CD8 and CD4/CD8 were observed after treatment (P＞0.05). Patients' quality of life in the therapeutic group was superior to that in the control group, with a significant difference (P＜0.05). Conclusion: APS in combination with 3D-CRT can reduce the side effects of radiation and improve the quality of life of elderly patients with NSCLC.