肿瘤预防与治疗2025，Vol.38Issue(6)：484-493,10.DOI:10.3969/j.issn.1674-0904.2025.06.005
吡非尼酮联合糖皮质激素治疗食管癌放射性肺炎的疗效
Observation on the Therapeutic Effect of Combination Therapy with Pir-fenidone and Glucocorticoids for Radiation Pneumonitis Induced by E-sophageal Cancer Radiotherapy
摘要
Abstract
Objective:To observe the clinical efficacy of pirfenidone(PFD)combined with glucocorticoids(GCs)in the management of esophageal cancer patients complicated by a-cute radiation pneumonia(ARP).Methods:We retrospectively analyzed the clinical data of 93 patients with ARP after in-tensity-modulated radiation therapy for esophageal cancer,admitted to Chenggong Hospital of Xiamen University between February 2017 and September 2024.Fourty-five patients in the control group received either prednisone or a combination of prednisone and dexamethasone,and 48 patients in the study group received PFD in addition to the treatment regimen of the control group.The clinical outcomes,recurrence rates,duration of pulmonary symptom improvement,changes in Karnofsky score,lung function parameters,T-cell subpopulation levels,and relevant cytokine profiles were assessed before and after treatment in both groups.Additionally,treatment-related adverse events were documented.Results:The study group demon-strated a significantly higher treatment response rate of 95.8％(46/48)compared to 80.0％(36/45)in the control group(P=0.018).Although the recurrence rate was lower in the study group(8.7％;4/46)than in the control group(13.9％;5/36),this difference was not statistically significant(P=0.696).Notably,the study group experienced a shorter duration of relief of pulmonary symptoms and resolution of rales(P＜0.05 for both).Post-treatment assessments revealed that both groups showed increased Karnofsky scores,CD4+levels,and CD4+/CD8+ratio,decreased CD8+levels,increased carbon monoxide diffusing capacity,forced expiratory volume in 1 second,and lung capacity levels,decreased tumor necrosis factor-α,interleukin-8,and transforming growth factor-β1 levels,and increased interleukin-10 and superoxide dismutase levels af-ter treatment(P＜0.05 for all comparisons).Importantly,the study group exhibited superior improvements in all these meas-ures compared to the control group(P＜0.05 for all).The overall incidence of adverse events was comparable between the two groups(16.7％ in the study group and 11.1％in the control group;P=0.440),and all events were graded as 1-2 in severity.Conclusion:The combination therapy of PFD and GCs in the treatment of esophageal cancer patients with ARP demonstrates synergistic efficacy,resulting in accelerated symptom relief,improved lung function and quality of life.This treatment regimen is well-tolerated and associated with a manageable safety profile.关键词
食管癌/放射性肺炎/吡非尼酮/糖皮质激素/临床疗效Key words
Esophageal cancer/Radiation pneumonia/Pirfenidone/Glucocorticoids/Clinical efficacy分类
临床医学引用本文复制引用
邱国钦,陈肖珏,吴文达,陈金平,陈思敏..吡非尼酮联合糖皮质激素治疗食管癌放射性肺炎的疗效[J].肿瘤预防与治疗,2025,38(6):484-493,10.基金项目
This study was supported by grants from Science and Technology Bureau of Xiamen(No.3502Z20194055,No.3502Z20244ZD1245),Health Commission of Xia-men(No.2024GZL-CX59)and the Science and Tech-nology Department of Xiamen University(No.XDHT2019206A). 厦门市医疗卫生科技计划项目(编号:3502Z20194055) （No.3502Z20194055,No.3502Z20244ZD1245）
厦门市医疗卫生指导性项目(编号:3502Z20244ZD1245) （编号:3502Z20244ZD1245）
厦门市卫生健康高质量发展科技计划项目(编号:2024GZL-CX59) （编号:2024GZL-CX59）
厦门大学科技处课题(编号:XDHT2019206A) （编号:XDHT2019206A）
