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目的 探讨后程加速超分割放射治疗同期给予单药顺铂化疗对食管癌患者细胞免疫功能的影响。方法 将符合入选条件的 10 4例食管鳞癌患者随机分为A、B 2个组。A组 5 3例为后程加速超分割放射治疗组 (简称后超组 ) ;B组 5 1例为后超加顺铂组。放射治疗方法 2个组相同 ,顺铂于放射治疗第 1、5周分别给予 2 0mg/d ,连续 5d。治疗前和结束时分别采取外周血 ,用流式细胞术测定淋巴细胞CD4、CD8、CD5 6抗原的阳性率。结果 治疗后CD4与CD8比值较治疗前明显下降 (A组P<0 .0 1,B组P <0 .0 1) ,CD5 6阳性率则升高 (A组P <0 .0 1,B组P <0 .0 1) ,但上述 2项指标的变化在2个组间差异无显著性意义 (P >0 .0 5 )。结论 后程加速超分割放射治疗加顺铂治疗后可使食管癌患者的细胞免疫水平 (CD4 /CD8)降低 ,而NK细胞 (CD5 6 )免疫监视活性部分恢复或增强。
Objective To investigate the effects of delayed-course accelerated hyperfractionation radiotherapy on cellular immune function in patients with esophageal cancer treated with cisplatin alone. Methods A total of 104 esophageal squamous cell carcinoma patients who met the inclusion criteria were randomly divided into A and B groups. Fifty-three patients in group A underwent accelerated hyperfractionated radiotherapy (abbreviated as super-super-group), while 51 patients in group B received post-super-plus cisplatin. Radiotherapy methods were the same in the two groups. Cisplatin was given to 20 mg / d for the first 5 days of radiotherapy for 5 days. Peripheral blood was taken before and at the end of treatment, and the positive rates of CD4, CD8 and CD5 6 antigen in lymphocytes were determined by flow cytometry. Results After treatment, the ratio of CD4 to CD8 decreased significantly (P <0.01 in group A, P <0.01 in group B) and the positive rate of CD5 6 in group A (P <0.01, B Group P <0. 01), but there was no significant difference between the two groups in the above two indexes (P> 0.05). Conclusions Post-course accelerated hyperfraction radiotherapy plus cisplatin treatment can reduce the level of cellular immunity (CD4 / CD8) in esophageal cancer patients, while the immune surveillance activity of NK cells (CD5 6) partially regained or increased.