rhGM-CSF联合康复新液对乳腺癌放射性皮炎的预防效果

doi:10.11958/20250747

摘要/Abstract

摘要：

目的探讨重组人粒细胞巨噬细胞集落刺激因子（rhGM-CSF）联合康复新液对乳腺癌患者放射性皮炎的预防效果。方法纳入乳腺癌患者90例并随机分为对照组和观察组，各45例。2组均接受放疗，对照组采用rhGM-CSF预防放射性皮炎，观察组采用rhGM-CSF联合康复新液预防。比较2组放射性皮炎发生情况、首次发生时间、痊愈时间。于放疗前、放疗结束后2周分别采用酶联免疫吸附试验检测皮肤生长因子[表皮生长因子（EGF）、碱性成纤维细胞生长因子（bFGF）、转化生长因子-β（TGF-β）]水平；并采用欧洲癌症研究与治疗组织生活质量核心问卷3.0版（QLQ-C30 V3.0）评估患者生活质量。结果观察组放射性皮炎发生率[35.56%（16/45）]低于对照组[68.89%（31/45）]，且皮炎首次发生时间较晚、痊愈时间缩短、严重程度分级更低（P<0.05）。放疗结束后2周，2组EGF、bFGF、TGF-β水平及QLQ-C30各项评分均升高，且观察组高于对照组（P<0.05）。结论 rhGM-CSF联合康复新液可有效预防乳腺癌患者的放射性皮炎，显著降低其发生率、延迟发生时间、减轻严重程度并加速痊愈，改善患者生活质量。

关键词: 乳腺肿瘤, 放射性皮炎, 粒细胞巨噬细胞集落刺激因子, 康复新液

Abstract:

Objective To investigate the preventive efficacy of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) combined with Kangfuxin liquid on radiation dermatitis in breast cancer patients underwent radiotherapy. Methods A total of 90 breast cancer patients were randomized into the control group (45 cases, rhGM-CSF alone) and the observation group (45 cases, rhGM-CSF + Kangfuxin liquid). Both groups received radiotherapy. The incidence of radiation dermatitis, the time of first occurrence, the healing time and severity of radiation dermatitis (graded by RTOG criteria) were compared between the two groups. Skin growth factors [epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), transforming growth factor-β (TGF-β)] were measured via enzyme linked immunosorbent assay (ELISA) before radiotherapy and 2 weeks after radiotherapy. The quality of life of patients was assessed using the EORTC QLQ-C30 V3.0 questionnaire. Results The incidence of radiation dermatitis was significantly lower in the observation group (35.56%, 16/45) than that in the control group (68.89%, 31/45, P<0.05), and the first occurrence time of dermatitis was later, the healing time was shorter, and the severity grade of dermatitis was lower (P<0.05). Two weeks after radiotherapy, levels of EGF, bFGF, TGF-β and the scores of QLQ-C30 increased in both groups, and those of the observation group were significantly higher than the control group (P<0.05). Conclusion Combining rhGM-CSF with Kangfuxin liquid can effectively prevent radiation dermatitis in breast cancer patients by reducing incidence and severity, delaying onset time, accelerating healing, and improving quality of life.

Key words: breast neoplasms, radiodermatitis, granulocyte-macrophage colony-stimulating factor, Kangfuxin liquid

中图分类号:

R730.5，R758.13

图/表 4

参考文献 22

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组别	年龄/岁			BMI/（kg/m²）		月经状态
组别	年龄/岁			BMI/（kg/m²）		绝经		未绝经
对照组	53.53±15.84			21.13±2.37		27（60.00）		18（40.00）
观察组	53.71±16.08			20.95±2.12		29（64.44）		16（35.56）
t或χ²	0.053			0.375		0.189
组别		病变部位			TNM分期
组别		左胸	右胸		Ⅱ期		Ⅲ期
对照组		30（66.67）	15（33.33）		25（55.56）		20（44.44）
观察组		28（62.22）	17（37.78）		26（57.78）		19（42.22）
χ²		0.194			0.045

组别	年龄/岁			BMI/（kg/m²）		月经状态
组别	年龄/岁			BMI/（kg/m²）		绝经		未绝经
对照组	53.53±15.84			21.13±2.37		27（60.00）		18（40.00）
观察组	53.71±16.08			20.95±2.12		29（64.44）		16（35.56）
t或χ²	0.053			0.375		0.189
组别		病变部位			TNM分期
组别		左胸	右胸		Ⅱ期		Ⅲ期
对照组		30（66.67）	15（33.33）		25（55.56）		20（44.44）
观察组		28（62.22）	17（37.78）		26（57.78）		19（42.22）
χ²		0.194			0.045

组别	发生例数	首次发生时间/d	痊愈时间/d	严重程度（RIOG分级）
组别	发生例数	首次发生时间/d	痊愈时间/d	1—2级	3—4级
对照组	31（68.89）	10.61±3.07	20.17±1.56	18（58.06）	13（41.94）
观察组	16（35.56）	14.03±3.45	16.29±1.33	14（87.50）	2（12.50）
χ²或t	10.020^＊	4.967^＊	12.696^＊	4.208^＊

组别	发生例数	首次发生时间/d	痊愈时间/d	严重程度（RIOG分级）
组别	发生例数	首次发生时间/d	痊愈时间/d	1—2级	3—4级
对照组	31（68.89）	10.61±3.07	20.17±1.56	18（58.06）	13（41.94）
观察组	16（35.56）	14.03±3.45	16.29±1.33	14（87.50）	2（12.50）
χ²或t	10.020^＊	4.967^＊	12.696^＊	4.208^＊

组别	EGF/（ng/L）			bFGF/（ng/L）			TGF-β/（μg/L）
组别	放疗前	放疗后	t	放疗前	放疗后	t	放疗前	放疗后	t
对照组	6.43±1.44	8.74±1.46	7.556^＊	0.76±0.15	1.46±0.29	14.382^＊	6.51±0.46	8.59±0.27	26.159^＊
观察组	6.47±1.41	10.88±2.30	10.966^＊	0.75±0.12	2.43±0.55	20.020^＊	6.52±0.45	10.71±0.42	45.662^＊
t	0.138	5.498^＊		0.349	10.920^＊		0.108	29.721^＊