摘要
目的:观察单药多西他赛周疗联合3D-CRT同步对局部晚期非小细胞肺鳞癌AI、MVD的影响,MVD、AI与T0.5三者间的相关性,探讨多西他赛放疗增敏的分子生物学机制。方法:60例均经病理证实为鳞癌的初治病人入组,临床分期Ⅲa-Ⅲb。随机分为两组,观察组:(3D-CRT+多西他赛增敏+辅助化疗)30例,从放疗第1天开始,多西他赛静脉滴注(36mg/m2),每周1次,共6周,放疗结束后TP方案化疗4周期;对照组(3D-CRT+辅助化疗)30例,放疗结束后TP方案化疗4-6周期。放疗前及放疗(20Gy)后的24小时内,各行支气管镜活检1次,两次取材部位相同。采用免疫组化染色SP法对肿瘤标本进行微血管密度(MVD)检测,TUNEL法检测肺癌细胞凋亡标记指数(AI),计算肿瘤缩小50%所需的时间(T0.5)。结果:观察组MVD表达降低较对照组有明显差异(P<0.05),观察组治疗前后诱导AI增加较对照组有明显差异(P<0.05),MVD表达降低与T0.5呈负相关(r=-0.624,P<0.05),AI表达增加与T0.5没有相关性。结论:多西他赛有可能通过降低MVD表达、诱导AI增加达到放疗增敏的目的,单药多西他赛周疗联合3D-CRT可有效改善局部晚期非小细胞肺鳞癌患者的预后,从而提高病人的生活质量。
Objective：To evaluate the efficacy of a weekly administration of docetaxel plus 3D-CRT in patients with locally advanced non-small squamous cell lung cancer,and to investigate the correlation among the micro-vessel density （MVD）,apoptotic index （AI） and T0.5,as well as the molecular biology mechanism of docetaxel increasing the sensitivity of radiotherapy.Methods：All 60 patients （stage Ⅲ a-Ⅲ b） with histologically confirmed squamous cell lung carcinoma were randomly divided into observation group（n =30） and control group（n =30）.The observation group（3D-CRT plus docetaxel plus adjuvant chemotherapy）：a 6-week administration of weekly docetaxel （36mg/m2,i.v.gtt）plus 3 D-CRT was synchronized on day 1 followed by 4 cycles of TP scheme.The control group （3D-CRT plus adjuvant chemotherapy）：the same as observation group,except the intervention of docetaxel.Biopsies via video bronchoscope were performed in the same bronchioles before and after radiotherapy（20Gy）.Immunohistochemistry was used to assess MVD,TUNEL to calculate AI,and the index of T0.5 evaluated the time of 50％ tumor regression.Results：The MVD of observation group was significantly lower than the control group （P ＜ 0.05）.The A-LI of observation group was significantly higer than the control group（P ＜ 0.05）.The decrease of MVD and T0.5 in observation group showed an obvious negative correlation（r =-0.624,P ＜0.05）.Conclusion：Docetaxel may be an effective radiosensitizing agent through inhibiting the density of microvessels and inducing the apoptosis of the locally advanced non-small squamous cell lung cancer.The docetaxel combined with 3D-CRT can significantly improve the treatment and prognosis of locally advanced non-small squamous cell lung cancer.
出处
《现代肿瘤医学》
CAS
2013年第9期1981-1984,共4页
Journal of Modern Oncology
基金
泰安市科技局计划课题资助项目(编号:20103060)
关键词
多西他赛
化疗
肺癌
鳞状细胞癌
放疗
微血管密度
细胞凋亡
docetaxel
chemotherapy
lung-cancer
squamous cell carcinoma
radiotherapy
microvessel density
apoptosis
