Evaluation Of Hyperthermia Combined With Chemoradiotherapy In Locally Advanced Non-small Cell Lung Cancer And Its Changes Of Peripheral Blood Lymphocyte Subsets

BackgroundConcurrent radiotherapy and chemotherapy is the standard treatment for patients with inoperable locally advanced NSCLC(Non-small Cell Lung Cancer).However,in the real world,some factors such as poor patient compliance,multiple adverse reactions,and long treatment cycles restrict the clinical application of concurrent radiotherapy and chemotherapy.Irregular treatment makes some patients unable to achieve long-term survival.In addition,the lung,as an organ exposed to the external antigen environment,has a special immunogenicity,which may be one of the reasons for its poor therapeutic effect.Recent studies have shown that hyperthermia,as an adjuvant anti-tumor therapy,can kill tumor cells in a reasonable and effective combination with radiotherapy and chemotherapy,and can also enhance the sensitivity of conventional therapies,improve the local control rate,and may even improve the long-term The role of survival.More importantly,hyperthermia,through its powerful immunogenic effects,has shown good prospects in regulating the tumor immune microenvironment,and it is worthy of in-depth exploration.PurposeTo analyze the effect of hyperthermia combined with concurrent radiotherapy and chemotherapy on patients with locally advanced NSCLC,adverse reactions,quality of life improvement,and the impact of peripheral blood lymphocyte subsets.MethodCollected from January 2017 to May 2019,patients with locally advanced NSCLCwho were inoperable after pathological diagnosis and multidisciplinary discussion in Qingdao Municipal Hospital.According to the inclusion criteria of this study,a total of71 patients with locally advanced NSCLC were finally included,whether combined with hyperthermia is the basis for grouping,the concurrent radiotherapy and chemotherapy combined with hyperthermia group was named the observation group,and a total of 32 cases were included;the concurrent radiotherapy and chemotherapy group was named as the control group,and a total of 39 cases were included.The Lianzhong digital electronic medical record system of our hospital was used to collect and integrate the patient’s inpatient and outpatient information,and followed up by telephone to assess the general condition,efficacy(RECIST1.1 standard),adverse reactions,improvement of quality of life,and peripheral hemolymph of the two groups of patients The main indicators of cell subpopulations were analyzed by medical statistics to compare whether there were statistical differences between the two groups of patients before and after treatment.Statistical methods:Measurement data are expressed as mean±standard deviation((?)±s).Two independent sample t-tests are used for sample comparison between the two groups,paired t-tests are used for comparison of the same group of patients before and after treatment,and the Kaplan-Meier method is used to draw survival curves.The log-rank method was used for survival analysis.P<0.05 indicates that the difference is statistically significant.ResultThere was no statistical difference between the two groups of patients in general conditions(P>0.05);the ORR of the observation group was 90.6%,while the ORR of the control group was 69.2%,the observation group was higher than the control group,and the difference was statistically significant(P=0.04);The observation group had DCR 96.9%,and the control group had DCR 92.3%.The observation group was better,but there was no statistical difference(P>0.05);the observation group m PFS8.8m,the control group m PFS8.4m,the observation group was longer than the control group,but The difference was not statistically significant(P>0.05);there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05),but the incidence of severe bone marrow suppression(grade 3 and above)in the observation group was significantly lower than that in the control group(P=0.017);A total of 15 patients in the observation group were judged to be clinically effective and quality of life improved,with an improvement rate of 46.9%;only 9 patients in the control group were judged to be clinically effective and quality of life improved,with an improvement rate of 23.1%.The improvement of the quality of life of the two groups was significantly different(P=0.045);the main monitoring indicators of peripheral blood lymphocyte subsets before treatment were not statistically different between the groups(P>0.05),and the observation group CD3~+,CD4~+,CD4~+/CD8~+increased after treatment,CD8~+decreased,but no significant difference(P>0.05),NK cell count increased,and regulatory T cell count decreased significantly(P<0.05);after treatment,the control group CD3~+,CD4~+,CD4~+/CD8~+Decrease,CD8~+,NK cells increased,and regulatory T cell counts decreased,but the difference was not statistically significant(P>0.05).ConclusionThe short-term curative effect of hyperthermia combined with concurrent radiochemistry in the treatment of locally advanced NSCLC patients is better than concurrent radiotherapy and chemotherapy.The incidence of severe myelosuppression is low,the tolerability is good,the quality of life is improved,and the immune function is positively regulated.