西咪替丁合并放疗对老年鼻咽癌患者免疫功能的影响及疗效

发布时间：2018-08-05 20:41

【摘要】：目的探讨西咪替丁合并放疗对老年鼻咽癌患者的治疗作用。方法老年鼻咽癌患者60例随机分为对照组和西咪替丁组各30例。对照组与西咪替丁组都给予直线加速器行外照射放疗,原发灶放疗剂量为70~75 Gy/7~8 w,西咪替丁组加用西咪替丁口服,按30~35 mg·kg-1·d-1计算,qid,其中21例口服4个月,9例口服5~6个月。两组患者于治疗前和治疗后抽取外周血检测CD3、CD4、CD8、CD4/CD8、NK水平,统计两组患者5年生存率、5年肿瘤复发率和远期并发症的情况。结果放疗组治疗前后CD4和NK水平都有明显的改变(P0.05),而CD3、CD8和CD4/CD8治疗前后无明显改变(P0.05),西咪替丁组治疗后CD4、CD8、CD4/CD8和NK水平与治疗前有明显的改善(P0.05);与放疗组相比,西咪替丁联合放疗能够显著改善CD8、CD4/CD8和NK的水平(P0.05),而两组治疗后的CD3和CD4水平无明显差异(P0.05)。放疗组和西咪替丁联合放疗组的5年生存率分别为59.26%和67.86%,两者无明显差异(P0.05),而放疗组肿瘤5年复发转移率(48.15%)明显高于西咪替丁组(21.43%)(P0.05);放疗组有13例患者出现颈肌纤维化、放射性中耳炎和张口受限等并发症,与西咪替丁联合放疗组相比无明显差异(P0.05)。结论西咪替丁具有较好的免疫调节作用,并且价格低廉、安全有效,但具体作用机制尚需证实。
[Abstract]:Objective to investigate the effect of cimetidine combined with radiotherapy on elderly patients with nasopharyngeal carcinoma. Methods 60 patients with nasopharyngeal carcinoma were randomly divided into control group and cimetidine group. The control group and cimetidine group were given external irradiation with linear accelerator. The primary dose of radiotherapy was 70 ~ 75 Gy/7~8. Cimetidine plus cimetidine was given orally, and the dose of cimetidine was 30 ~ 35 mg / d ~ (-1). Among them, 21 cases were given orally for 4 months or 9 cases for 5 ~ 6 months. The peripheral blood samples were taken from the patients before and after treatment to detect the NK level of CD3 + CD4 + CD8 / CD8 / CD8 / CD8. The 5-year survival rate, 5-year recurrence rate and long-term complications of the two groups were calculated. Results there were significant changes in CD4 and NK levels before and after treatment in the radiotherapy group (P0.05), but there were no significant changes in CD3C8 and CD4/CD8 before and after treatment (P0.05). The levels of CD4 / CD8 / CD8 and NK in cimetidine group were significantly improved after treatment (P0.05). Cimetidine combined with radiotherapy could significantly improve CD8 / CD8 and NK levels (P0.05), but there was no significant difference in CD3 and CD4 levels between the two groups (P0.05). The 5-year survival rates of radiotherapy group and cimetidine combined radiotherapy group were 59.26% and 67.86%, respectively. There was no significant difference between the two groups (P0.05), while the 5-year recurrence and metastasis rate in radiotherapy group (48.15%) was significantly higher than that in cimetidine group (21.43%) (P0.05). There was no significant difference between radiation otitis media and limited mouth opening compared with cimetidine combined radiotherapy group (P0.05). Conclusion cimetidine has good immunomodulatory effect, low price, safe and effective, but the mechanism of cimetidine still needs to be proved.
【作者单位】：南阳市中心医院放疗科;
【分类号】：R739.63

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