Effect Of The Level Of Endogenous Melatonin On The Immune Function And The Quality Of Life Of The Elderly Non-Small Cell Lung Cancer Patients

Objective Prospective clinical research was carried out by using the amino acid parenteral nutrition (PN),including the melatonin synthesis substrate,tryptophan (Try),to the elderly non-small cell lung cancer (NSCLC) patients during the chemotherapy period. We want to analysis the effect of the amino acids PN including tryptophan on the level of endogenous melatonin of the elderly NSCLC patients through detecting the melatonin(MT) concentration fluctuate in the serum at the different amino acid PN dosage before and after the chemotherapy. We also want to make clear the effect of endogenous melatonin on immunal system of the elderly NSCLC patients by observing some immunal assays and the change of quality of life before and after this PN therapy. Experimental support will be provided by these data to the elderly tumor patients'rational nutritional .Methods 61 elderly NSCLC patients were divided into three groups randomly,500 ml/d amino acids PN and chenmotherapy group,250ml/d amino acids PN and chemotherapy group and only chemotherapy group. Same NP (cis-dichlorodiamine platinum+Vinorelbine) chemotherapy was carried out.During three chemotherapy periods,we provide amino acids PN therapy to the amino acids PN therapy groups. We detected the MT concentration changes in the serum before and after the course of treatment,and observed the changes of NK cell count,T cell subgroup,IgG,IgM in blood and the changes of quality of life . Resultsâ‘ There the discrepancy of the serum MT in day and in night are existed in three groups,the concentration of MT in the serum is significant higher at 0:00 at night than at 12:00 in the day.â‘¡After the third course of treatment,the level of serum MT in three group patients are all lower than before the first course of treatment (P<0.01orP<0.05). After the third course of treatment,the level of serum MT in the only chemotherapy group are significant lower than the amino acids PN therapy groups(P<0.01),but there is no significant deviation between the different dosages amino acid PN group.â‘¢After the third course of treatment,the concentration of NK cell,CD3+,CD4+ cell percentage,CD4+ / CD8+ ratio and IgG in blood are lower than the first course of treatment at different levels(P<0.01orP<0.05),the CD3+ cell percentage,CD4+ cell percentage and IgG density in blood of 500ml amino acids PN therapy group are higher than the other two group(P<0.05).â‘£The quality of life of the patients who have the growth of endogenous MT was better than the other patients including the only chemotherapy group(P<0.05).Conclusionsâ‘ During the chemotherapy of the old age NSCLC patients,the discrepancy of the MT low at night and high in the day phenomenon still exists.â‘¡NP chemotherapy can cause the descent of patients'MT,but to provide amino acids PN which including Try can prevent the descent of MT.â‘¢After the chemotherapy,the cell immune function and humoral immune function of elderly NSCLC patients are descendent , the growth of endogenous melatonin can lessen the effect of the chemotherapy to the cell immune function (CD3+ cell percentage) and humoral immune function(serum IgG density).â‘£The growth of endogenous melatonin is good to improve the quality of life of the old age NSCLC patients with chemotherapy.