| Purpose:To investigate the efficacy of the compound MaXingShiGan decoction on radiation induced lung injury(RILI) in patients with stage III non-small cell lung cancer(NSCLC) caused by concurrent chemoradiation therapy(CCRT) and to study the effect to fit on transforming growth factor-betal(TGF-β1) levels in plasma.Methods:Sixty-seven patients suffering from stage III NSCLC from October 2014 to December 2015 underwent CCRT. All cases were randomly divided into two groups, the trial group and the control group. The trial group was treated with the compound MaXingShiGan decoction and CCRT, while the control group was treated with CCRT only. Ages, genders, general conditions, tumor histological types and pathologic grades between two groups were compared. Corticosteroid, oxygen-inhalation-therapy, antiasthmatic drugs or antibiotics were given to relieve RILI as necessary. KPS, efficacy, RILI of each case was recorded. The severity grade of RILI according to NCI-CTCAE4.0. Occurrence and duration of adverse drug reactions (ADRs) as well as symptom, degrees and treatment measures were recorded during or after therapy according to Provision for Adverse Drug Reaction Reporting and Monitoring (Order No.81 of the Ministry of Health). The levels of TGF-β1 in plasma collected on the time points of one week before CCRT, just after CCRT and 5 weeks after CCRT were detected by enzyme-linked immunosorbent assay (ELISA).Results:1. Incidence rates of RILI:The incidence rates of RILI of two groups were 10% and 34% respectively, there were significant difference between the two groups in the incidence rates of RILI (p<0.05).2. Grade of RILI:There was no case suffering from grade 5 RILI in both groups. There were 1,1,1,0 cases with grade 1,2,3 and 4 of RILI in trial group and 2,5,3,1 cases with grade 1,2,3 and 4 of RILI in control group. There were 2 cases and 9 cases suffering from RILI (≥grade 2) in trial group and control group respectively, there were significant difference between the two groups (p<0.05).3. Recent treatment effect of tumor:After 5 weeks of CCRT, the number of trial group and the control group achieved CR, PR, SD, PD were 2,15,10,2 cases and 2,18,9,4 cases respectively. The effective rates of two groups were 58% and 62% respectively, so there were no significant difference between two groups (p>0.05).4. General conditions(KPS):There was no obvious difference in KPS scores before CCRT between two groups (p>0.05). The KPS scores were higher in the trial group compare with the control group after CCRT and 5 weeks after CCRT (p<0.05).5. Adverse reactions:There was one patient suffering from improper metabolism of glucose in the control group. No significant difference in the incidence rates of ADRs was found between two groups.6. Levels of plasma TGF-β1:There were no significant difference between two groups before CCRT(p>0.05). After treatment of CCRT, the levels of plasma TGF-β1 in two groups increased and levels of plasma TGF-β1 were higher in the control group as compared to trial group (p<0.05). The levels of plasma TGF-β1 in two groups decreased 5 weeks after CCRT and levels of plasma TGF-β1 were lower in trial group(p<0.05).Conclusion:1. Compound MaXingShiGan decoction can reduce the incidence rates and grade of RILI and improve life quality in patients with stage III NSCLC received CCRT. It is indicated that the Compound MaXingShiGan decoction may prevent and treat RILI.2. Compound MaXingShiGan decoction can reduce the levels of plasma TGF-β1 in cases suffering from stage III NSCLC treated with CCRT, which showed that modes of actions may be relevant to decreased levels of plasma TGF-β1. |
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