Analysis Of Effect-enhancing And Toxicity-reducing Effect Of Amifostine In Chemotherapy Of Extensive Small-cell Lung Cancer

Objective:Lung Cancer is a common malignat tumer,which are often reached an advanced stage when they are found.Lung cancer,as per histopathology,can be classified into small cell lung cancer(SCLC)and non-small cell lung cancer.The former has more unique biological features,higher malignancy,more severe invasiveness and faster proliferation.It is prone to the occurrence of distant metastasis,thus yielding worse prognosis.Chmotherapy is the main method for the treatment of small-cell lung cancer.But the chemotherapeutics are lethal to tumer cell and normal cell.So the uptoward effect and dose-limiting toxicity usually imposed restrictions on the sufficiency of using chemotherapeutics and caused the worst prognosis for patients.But amifostine as a clinical practice of the cell protector soloved the above problem effectively.Because of this,the Amifostine are widely applied in the chemotheray at home and abroad,which can reduce the toxicity during the chemotheray.The4IP(CPT-11/DDP)scheme is one of the most commonly used method during the chemotheray SCLC.However the untoward effect of the IPscheme can not be ingnored.In view of less clinical report in the domestic and abroad documents about that the amifostine could enhance effect and reduce the relevant toxicity caused by the chemotheray,so this study will apply to use amifostine in chemotheray of extensive SCLC and observe the effect-enhancing and toxicity-reducing effect of the amifostine during the chemotheray,in order to better guide clinical medication.Methods:This research randomly collects the patients with small-cell lung ca-ncer who are diagnosed and initially treated in the Oncology department of No.2Hospital of Da Lian Medical University between Sep 2012 and Sep 2015.There are 39 cases in the experimental group(amifostine combined with IP regimen)and 30 cases in the con-trol group(simple IP regimen),all together 69 cases.(54 male and 15 female,age ranging from 40 to 80)Based on the staging meth-od of limited disease(LD)and extensive disease(ED)proposed by the Veterans Administration Lung Study Group(VALG),the patients in this research are all with extensive small-cell lung cancer who have measurable tumor focus by CT s-cans.The selected patients all adopt IP chemotherapy,21 days is one cycle.After four cycles' treatment,acc-ording to WHO criteria for acute and subacute toxic r-eaction of anticancer drugs and RECIST method,analysing the effect-enhancing and toxicity-reducing effect of the amifostine during the chemotheray.Using SPSS21.0 statistical software to m-ake data analysis.Measurement data adopts mean±sta ndard deviation method for s-tatistical description.Numeration data adopts rate fo-r statistical description.The i-ntergroup comparison of measurement data is expressed by t-test and analysis of variance.The intergroup comparison of enumerati on data is expressed by x2 test.And the comparison of monomial ordinal data is expressed by non-parametric te-st.A P value less than 0.05 is considered statisti-cally significant.Result:1.Curative effect comparison after 4 cycles' chemotherapy:the result5 shows that there are CR 0 case,PR 34 cases(87.2%),SD 4 cases(10.3%)and PD 1case(2.6%)in amifostine combined IP regimen group,and there are CR 0 case,PR 27cases(90%),SD 1 case(3.3%),and PD 2 cases(6.7%)in single IP regimen group.By statistical tests,the differences of the curative effect comparison between two groups are not statically significant(P=0.78),see Table 2.2.Myelotoxicity comparison : the quantitative analysis shows the differences in leukocyte,neutrophil,hemoglobin and blood platelet are all statically significant(P<0.05).The average value of the group with amifostine is higher than the group without amifostine.The qualitative comparison of the bone marrow suppression induced by chemotherapy also shows the differences in leukocyte,neutrophil,hemoglobin and blood platelet are statically significant(P<0.05).The suppression of the group with amifostine is lower than the group without amifostine,see table 3-1 and 3-2 respectively.3.Hepatotoxicity comparison:The value of the group with amifostine is lower than the group without amifostine,see table 4-1.the quantitative analysis shows the differences in AST,ALT and TBIL are statically significant(P<0.05).The hepatotoxicity quantitative analysis shows the liver damage level of the group with amifostine is lower than the group without amifostine,and the differences are statistically significant(P<0.05),see table 4-2.4.Gastrointestinal reaction comparison:both groups happen nausea and vomiting,and the differences between two groups are not statically significant(P>0.05),see table 5.5.Nephrotoxicity comparison : The average value of the group with amifostine is lower than the group without amifostine.the quantitative analysis and qualitative analysis both show the differences between two groups are statically significant(P<0.05),see table 6-1,6-2.6.Neurotoxicity comparison : the differences between two groups are statically significant(P<0.05),see table 7.7.Lymphocyte subsets comparison:the result shows the differences in CD3,CD4,CD8 and NK are not statically significant,see table 7.Conclusion:1.Amifostine has no impact on the short-term efficacy of IP regimen chemotherapy with extensive small-cell lung cancer.2.Amifostine can reduce IP regimen chemotherapy's myelotoxicity,hepatotoxicity,nephrotoxicity,neurotoxicity and other toxic side effects in the treatment of patients with extensive small-cell lung cancer.It improves the quality of life of chemotherapy patients.