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Panminerva Medica 1999 June;41(2):129-33


lingua: Inglese

Radio- and chemotherapy variably affect the general immunocompetence of lung cancer patients

Vuckovic-Dekic L., Susnjar S., Stanojevic-Bakic N., Radosavljevic D.

From the Institute for Oncology and Radiology of Serbia National Cancer Research Center, Beograd, Yugoslavia


Objective. The eval­u­a­tion of the ­effects of radio­ther­a­py and chem­o­ther­a­py on the ­immune stat­us of ­lung can­cer ­patients.
Experimental ­design: prospective non­ran­dom­ized ­study. Setting: hospitalized ­care. Patients: 121 ­patients ­with unre­sect­able non-­small-­cell ­lung can­cer ( Stage IIIb or IV), who ­were ­planned for radio­ther­a­py (n=81) or chem­o­ther­a­py (n=40).
Measures: the rel­a­tive and abso­lute num­bers of ­blood T lym­pho­cytes and mono­cy­tes, as ­well as the mito­gen-­induced pro­life­ra­tive ­response of the for­mer, and phag­o­cyt­ing capac­ity of the lat­ter ­cell sub­pop­u­la­tion, ­were deter­mined in ­patients ­before start­ing any ther­a­py. In radio­ther­a­py (RT)-treat­ed ­group, the ­immune param­e­ters ­were eval­u­at­ed ­after 45 Gy and 60 Gy had ­been giv­en. In chem­o­ther­a­py (ChT)-treat­ed ­group, the ­same param­e­ters ­were deter­mined ­three ­weeks ­after the 2nd and 4th ­cycle of ChT.
Results. The num­ber and pro­life­ra­tive ­response of T lym­pho­cytes ­were sig­nif­i­cant­ly (p<0.001) low­er, ­while the num­ber and phag­o­cyt­ing capac­ity of mono­cy­tes ­were sig­nif­i­cant­ly (p<0,001) high­er in all ­patients ­before ther­a­py, in com­par­i­son to the con­trols. After RT, the T ­cell num­ber and pro­life­ra­tive ­response ­were sig­nif­i­cant­ly (p<0.001) ­decreased, ­while the num­ber of mono­cy­tes and ­their phag­o­cyt­ing capac­ity ­remained ­unchanged, ­when com­pared to the pre­treat­ment val­ues. Unlike RT, chem­o­ther­a­py did not ­change any inves­ti­gat­ed param­e­ter, ­except for the phag­o­cyt­ing activ­ity of mono­cy­tes, ­which was sig­nif­i­cant­ly (p<0.02) ­decreased, in com­par­i­son to the pre­treat­ment val­ue, ­after ­four ­cycles of ChT ­only.
Conclusions. Two can­cer treat­ment modal­ities — ­radio- and chem­o­ther­a­py — var­i­ably ­affect the ­immune stat­us of ­lung can­cer ­patients. The ­initial ­great dis­tur­banc­es of gen­er­al immu­nity param­e­ters are fur­ther aggra­vat­ed by radio­ther­a­py. Unlike RT, chem­o­ther­a­py ­exerts no sup­pres­sion at all; on the con­trary, it ­tends to nor­mal­ize ­some of the param­e­ters of cel­lu­lar immu­nity of ­lung can­cer ­patients.

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