Effect Of The Melatonin Plus Chemotherapy On The Immune Function And The Partial Adverse Effects Of Chemotherapy Of Non-Small Cell Lung Cancer Patients

Objective: In order to evaluate the effect of melatonin plus chemotherapy on the serum concentration of melatonin, the immune function, chemotherapy adverse effects and clinical response, to provid evidence for non-small cell lung cancer (NSCLC) immunotherapy,prospective clinical research was carried out by using ectogenic melatonin, to NSCLC patients receiving chemotherapy.Methods: Forty-five patients who were divided into two groups randomized to receive chemotherapy(NP) alone (22 cases) or chemotherapy(NP) with melatonin(23 cases), The oral doses of 15mg/d were used without interruption in every evening during two chemotherapy periods. We detected the serum concentration of melatonin, the change of cell mediated immunity, NK and the hematology indexes before and after the chemotherapy. The clinical response was assessed after two cycles of chemotherapy. 20 volunteers as health control group were collected randomly from our hospital. Their serum melatonin were detected as data of control group.Results: The circadian rhythm exsited in all three groups, the serum level of melatonin at 0:00 was significantly higher than that at 12:00(P<0.01);The serum level of melatonin of two groups of study at 0:00 and 12:00 was significantly lower than that of health control group(P<0.01). After two cycles of chemotherapy, the level of melatonin at 0:00 was lower than that before chemotherapy, but the melatonin level in the MT group was significantly higher(P<0.05) than control group after chemotherapy(P<0.05).After two cycles of chemotherapy, the percentage of CD3+,CD4+ ,NK and the ratio of CD4+/CD8+ of control group was significantly lower than that before chemotherapy (P<0.05,0.01), but there was no significant difference in MT group. The percentage of CD4+ and the NK of MT group after chemotherapy was significantly higher than that of control group. While the percentage of CD8+ was lower. After two cycles of chemotherapy, the number of thrombocyte, lymphocyte, neutrophil and hemoglobin were significantly lower than that before chemotherapy, but there was no significant difference in MT group. The number of thrombocyte, lymphocyte and neutrophil of MT group after chemotherapy was significantly higher than that of control group. The number of hemoglobin of two groups was significantly lower after chemotherapy, and there was no significantly difference between two groups. The clinical response of two groups was 40.9% and 52.2% respectively, there was no significant difference between two groups.Conclunsion: The serum level of melatonin of NSCLC is lower than that of health group and more lower after two cycles of chemotherapy, but it show the circadian rhythm. The immunity especially cell mediated immunity was suppressed after chemotherapy. The percentage of NK, CD3+, CD4+ and the ratio of CD4+/CD8+ was lower, and the percentage of CD8+ was higher after chemotherapy. The oral melatonin during chemotherapy could prevent the decline of the percentage of CD4+, NK and the increase of the percentage of CD8+. Melatonin plus chemotherapy could prevent the occurrence of hematological toxicity during chemotherapy. There was no difference in clinical response between the two groups.