A Prelinary Study On The Efficacy Of Thalidomide In The Treatment Of Radioactive Pneumonia

ObjectiveRadiation pneumonia is a dose limiting complication of radiotherapy,usually occurs in 3~6 weeks after radiation therapy,which not only reduces the local tumor control rate,but also endangers the life of patients.At present,Glucocorticoid is mainly used to control the radiation pneumonia,but its adverse reaction is obvious,and it can reduce the immunity of the body.Therefore,it is urgent to need an effective treatment method.Thalidomide play a role in the regulation of anti-inflammatory,anti angiogenesis,immune.There have been confirmed thalidomide can reduce pulmonary fibrosis induced by bleomycin,also has been reported that thalidomide inhibits the formation of pulmonary fibrosis by reducing inflammation and fibrosis factors to reduce the early inflammatory response.But there are few people to study whether thalidomide has curative effect on radioactive pneumonia.Therefore,this study by animal experiment and clinical observation were studied,the experimental animals by measuring the serum levels of transformation growth factor beta 1(TGF-beta 1),interleukin-6(IL-6)and lung tissue stained with hematoxylin and eosin(he)staining on evaluation of alveolar inflammation and pulmonary fibrosis,study of thalidomide on radiation pneumonia if there is a role,to provide experimental evidence for the clinical treatment of radiation pneumonitis.Clinical aspects of 80 patients with thoracic tumor radiotherapy were collected,and the probability of occurrence of radiation pneumonia and the change of KPS were observed.This work aims to investigate the preventive effect of thalidomide on radiation pneumonitis and possible mechanism.1?An animal experimental study MethodsSPF grade healthy Wistar male rats were divided into control group,and the control group was given normal saline to fill the stomach.Model group with 6MV photons single irradiation of the right lung of rats,given normal saline daily gavage;Thalidomide groupwas the same as that of the model group as the right lung of rats,single 15 gy irradiation,daily at the same time to rat gastric lavage(gastric administration of thalidomide and saline with concentration of 1% solution).Blood and lung tissues were collected at first,3,and 5on Wednesday.The serum TGF-beta 1 and IL-6 were measured by Elisa method,and the staining of HE in lung tissue was observed.Results1.Changes of body mass at different time points in 3 groupsBody weight of the rats of model group and thalidomide group increased less than the blank group;The thalidomide group rats weight increased more significantly than the model group,the differences were statistically significant(p<0.01).2.The change of serum TGF-beta 1,IL-6 contentAll at the same time point in the model group and thalidomide group,the serum levels of TGF beta 1,IL-6 levels were higher than those of the control group,the difference was statistically significant(p<0.01);at the same time model group rats serum TGF beta-1,IL-6 levels were higher than those of thalidomide group,the difference is statistically significant(p<0.01).3.pathological results of lung tissueModel group: at the same time point model group,the HE staining results showed that the severity of pulmonary fibrosis and pulmonary fibrosis were higher than those in the control group.Thalidomide group: HE staining showed that 3 weeks and 5 weeks right pulmonary alveolitis and pulmonary interval increased badly wide levels were lower than the model group(p<0.05).At the 1st week of no statistical difference(p>0.05).Conclusion1.Thalidomide can improve the general condition of radiation pneumonia in rats.2.thalidomide can inhibit TGF-beta 1 expression of IL-6,inflammatory reaction and fibrosis.3.Thalidomide can reduce pulmonary fibrosis deposition in the animal model of radiation pneumonitis replication,and have a certain therapeutic effect on Radiation pneumonia Rats in the alveolar inflammation.2?Clinical research Methods80 cases of thoracic radiotherapy were collected and divided into the control group and the thalidomide group.Test group of patients with oral thalidomide dose of 100 mg/d,taking one before bed at night,from the first day of radiotherapy taking,has been taking to the end of radiotherapy;radiation pneumonitis occurred in two groups of patients are used hormones and antibiotics(infected)treatment,while giving oxygen,asthma,bronchiectasis etc.symptomatic treatment.The probability of occurrence of radiation pneumonia in the two groups was studied.At the same time,the KPS scores of two groups of patients at the end of radiotherapy were compared.ResultsThere was no significant difference in the probability of occurrence of radiation pneumonitis,thalidomide can reduce the level of radiation pneumonitis.The thalidomide group at the end of radiotherapy KPS scores were higher than the control group,and the difference was statistically significant(p=0.01).ConclusionThalidomide can reduce the damage degree of radiation on lung tissue,improve the general condition of patients.