论文部分内容阅读
目的:比较多次小剂量与大剂量放射免疫治疗(RIT)对实体瘤的初步临床疗效及不良反应。方法:采用多次小剂量188Re-CL58及大剂量131I-chTNT对临床病例治疗。用脱氧葡萄糖(FDG)-正电子发射断层扫描(PET)显像方法及动态观察血清中肿瘤标志物变化监测疗效。用间接免疫荧光法评价RIT对T淋巴细胞亚群的影响。观察其对造血系统和肝、肾等器官的不良反应。结果:多次小剂量188Re-CL58治疗后病灶部位的FDG摄取SUV值(Standarduptakevalue)均下降,对于小转移灶SUV下降更明显,且血清CEA等水平均下降,而大剂量131I-chTNT组CEA下降不及多次小剂量组明显。多次小剂量RIT后外周血CD4+细胞升高、CD8+细胞减少以及CD4+/CD8+比例升高,而大剂量RIT后CD4+/CD8+比例降低。大剂量组比多次小剂量组对白细胞、血小板、血色素的抑制明显,结论:多次小剂量188Re-CL58治疗效果优于大剂量131I-chTNT,且能解除肌体的免疫抑制;多次小剂量188Re-CL58治疗对造血系统抑制小于大剂量131I-chTNT。
OBJECTIVE: To compare the initial clinical efficacy and adverse reactions of low-dose and high-dose radioimmunotherapy (RIT) on solid tumors. Methods: The clinical cases were treated with multiple small-dose 188Re-CL58 and high-dose 131I-chTNT. Determine the effect of the changes of tumor markers in serum by FDG-PET imaging and dynamic observation. Indirect immunofluorescence was used to evaluate the effect of RIT on T lymphocyte subsets. Observed its hematopoietic system and liver, kidney and other organs adverse reactions. Results: After repeated low-dose 188Re-CL58 treatment, the FDG uptake of SUV (Standard uptake value) decreased and the decrease of SUV in small metastases was more obvious and serum CEA and other levels were decreased, while the CEA in high dose 131I-chTNT group was decreased Less than many low-dose group significantly. After low-dose RIT, CD4 + cells increased, CD8 + cells decreased and CD4 + / CD8 + increased, while the proportion of CD4 + / CD8 + decreased after high-dose RIT. The inhibition of leucocyte, platelet and hemoglobin in the high-dose group was more obvious than that of the low-dose group. Conclusion: 188Re-CL58 was better than the high-dose 131I-chTNT in many small doses and could relieve the body’s immunosuppression. 188Re-CL58 treatment inhibited hematopoietic system less than high dose 131I-chTNT.