放射治疗对肺癌患者细胞免疫功能的影响

Effect of radiotherapy on cellular immune function in patients with lung cancer

摘要:

探讨放射治疗（放疗）对非小细胞肺癌（NSCLC）患者细胞免疫功能的影响。方法对比分析48 例接受三维适形放疗的NSCLC 患者放疗前以及放疗第2、4、6 周及放疗后2 周血液中淋巴细胞、白细胞、中性粒细胞的水平的变化情况，计算不同时期淋巴细胞、白细胞、中性粒细胞水平低于正常范围的百分率。结果48 例肺癌患者的临床有效率为72.92%；接受放疗的大部分肺癌患者白细胞、中性粒细胞、淋巴细胞数目与放疗前相比出现下降；放疗结束后2 周白细胞、粒细胞可恢复正常水平，但部分患者淋巴细胞仍未能升至正常范围。结论三维适形放疗会对非小细胞肺癌患者免疫功能造成一定的损害，经过升白细胞治疗可提高白细胞、中性粒细胞水平，但对淋巴细胞无明显作用。放疗后肺癌患者淋巴细胞水平低下的现象值得进一步深入研究。

Abstract:

To investigate the effect of radiotherapy on cellular immune function in patients with nonsmall cell lung cancer (NSCLC). Methods In this study, 48 NSCLC patients accepted three-dimensional conformal radiotherapy. The peripheral white blood cell, lymphocyte and neutrophil levels were measured before radiotherapy,in the 2nd, 4th and 6th week during radiotherapy and 2 weeks after radiotherapy. The percentages of white blood cells, lymphocytes and neutrophils below normal range in different periods were calculated. Results The clinical efficiency of the 48 NSCLC patients was 72.92%. In the majority of the patients, the number of lymphocytes,leukocytes and neutrophils reduced after radiotherapy; the number of white blood cells and granulocytes could recover to the normal level 2 weeks after radiotherapy, but the number of lymphocytes failed to rise to the normal range in part of the patients. Conclusions Three dimensional conformal radiotherapy will cause certain damage to the immune function of the patients with non-small cell lung cancer. Leukocyte-elevating drugs can raise the number of white blood cells and neutrophils, but has no significant effect on the lymphocytes. The low lymphocyte level of the patients with lung cancer after radiotherapy is worth to be further studied.