Effect of concurrent chemoradiotherapy for serum matrix metalloproteinase 2 and transforming growth factor β1 in patients with locally advanced non-small cell lung cancer and its significance / 肿瘤研究与临床

ABSTRACT

Objective To compare concurrent chemoradiotherapy and sequential therapy effect on serum MMP-2 and TGF-β1 in local advanced non-small cell lung cancer (NSCLC).Methods From 2010 January to 2012 December,64 Ⅱ B and Ⅲ B stage patients with pathologically confirmed NSCLC were randomly divided into concurrent chemoradiotherapy group (group A) and sequential therapy group (group B).Each group had 32 patients.Group A was treated with three-dimensional conformal radiotherapy and concurrent chemotherapy with TC or EP.Group B received TC or EP regimen chemotherapy after three-dimensional conformal radiotherapy.Serum MMP-2 and TGF-β1 on those patients from preradiotherapy,radiotherapy in one month to post-treatment were measured by enzyme-linked immunoabsorbent assay.The dynamic changes of MMP-2 and TGF-β1 were compared.Results The remission rates in groups A and B were 90.6 ％ and 68.8 ％,the effective rate of treatment in group A was better than that of group B (x2 =4.730 0,P =0.029 6).The long-term effect analyzed with Kaplan-Meier method,the median time to tumor progression (TTP) were 9.1 months and 8.2 months,there was no statistically significant difference (P =0.100 3).The overall survival rates between two groups after the Log-rank test had significant difference (P =0.048),the median survival time (MST) were 17.8 and 15.9 months,1 year OS rates were 65.05 ％ and 60.24 ％,2 years OS rates were 49.45 ％ and 43.07 ％.The MMP-2 level of A group and B were (276.5±98.2) μg/ml and (263.9±103.5) μg/ml,there was no significant difference (t =0.499 6,P =0.619 1) before radiotherapy,they were (242.1±53.2) μg/ml and (298.7±68.4) μg/ml after radiotherapy,there was significant difference (t =3.694 9,P =0.005) and after treatment were (60.5 ±24.4) μg/ml and (75.2±30.7) μg/ml,there was significant difference (t =2.120 5,P =0.038 0).The TGF-β1 level of A group and B were (1 624.3±454.2) ng/ml and (1 564.9±517.8) ng/ml,there was no significant difference (t =0.208 6,P =0.835 4) before radiotherapy,they were (1 383.5±469.3) ng/ml and (1 785.3±412.6) mg/ml after radiotherapy,there was significant difference (t =3.637 3,P =0.006 0) and after treatment were (610.5±215.4) ng/ml and (750.3±263.7) ng/ml,there was significant difference (t =2.322 6,P =0.023 5).Conclusions Concurrent chemoradiotherapy could effectively antagonize radiation-induced MMP-2 and TGF-β1 expression increased in locally advanced NSCLC.This study suggests that the concurrent chemoradiotherapy can inhibit abilities of tumor invasion and metastasis through decreasing the MMP-2 and TGF-β1 levels.