Huangqifuzhengkeli Influence On The Incidence Of Radiation Pneumonitis From Radiotherapy Of Thoracic Malignant Tumors

Objective:1)To observe the incidence and degree of radiation pneumonitis in two groups before and after treatment, the efficacy and safety of huangqifuzhengkeli in preventing radiation pneumonitis; 2)To study the huangqifuzhengkeli influence on cytokine and T-lymphocyte through monitoring the changes of TGF–β1、IL–6、ACE and T-lymphocyte subsets in serum before and after the treatment between two groups of patients with radiotherapy to explore the possible mechanism of action and provide accurate scientific basis for clinical use.Method: According to inclusion criteria exclusive criteria 61 patients with lung cancer or esophageal cancer treated at ward two of radiotherapy in Gansu provincial tumor hospital was enrolled from January to December in 2014.Patients were divided into groups randomly.30 cases in the treatment group were treated with conventional radiotherapy combined with Huangqifuzhengkeli(specification:10g),which is oraled one bag each time,two times a day.31 cases in the control group were treated with conventional radiotherapy alone.All patients must received basic examination after admission include TGF-β1、IL-6、ACE and T-lymphocyte subsets in serum and lung function.The patients receive radiotherapy after CT stimulation、target volume contour and treatment plan validation.At the end of the radiotherapy reexamine serum TGF-β1、IL-6、ACE and T-lymphocyte subsets.Follow-up was done 1-3 month after the end of radiotherapy、clinical symptoms,lung function and CT were examined.Radiotherapy pneumonitis was determined by criteria of acute radiation injury from Radiation Therapy Oncology Group(RTOG).Results: 1 patient withdrew from the study because of serious nausea and vomiting side effects, 61 patients complete treatment, no significant differences between baseline data(P﹥0.05);The incidence rate of radiation pneumonitis was 10%(3/30)in the treatment group and 16%(5/31) in the control group. There was no significant difference in the incidence rate of radiation pneumonitis of between groups(P﹥0.05).The total of mature T cell、Th cell、NK cell、B lymphocyte、the ratio of CD4+/CD8+ before and after the treatment showed no statistical significance in treatment group(P﹥0.05), the total of mature T cell、Ts cell、 Th cell、NK cell、B lymphocyte、the ratio of CD4+/CD8+ before and after the treatment showed statistical significance in control group(P﹤0.05), the total of mature T cell、Ts cell、 Th cell、NK cell、B lymphocyte、the ratio of CD4+/CD8+ before and after the treatment in the two group was statistically significant different(P﹤0.05). IL–6 levels in serum before and after the treatment were no significant differences in treatment group(P﹥0.05)and were significantly different of control group(P﹤0.05). IL–6 levels in serum before and after the treatment in the two group was statistically significant different(P﹤0.01). TGF–β1 levels in serum before and after the treatment were significantly different between the two group(P﹤0.01). ACE levels in serum before and after the treatment were significantly different between the two group(P﹤0.01).Coclusion: Huangqifuzhngkeli can reduce the serum of patients with radiation in IL–6、TGF-β1 experssion and increasing the serum expression level of ACE in patients with radiation,at the some time,can reduce the damage degree of radiotherapy on T-lymphocyte subsets.