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

Objective. The evaluation of the effects of radiotherapy and chemotherapy o n the immune status of lung cancer patients. Experimental design: prospecti ve nonrandomized study. Setting: hospitalized care. Patients: 121 patients with unresectable non-sm all-cell lung cancer (Stage IIIb or TV), 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 prolif erative 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 afte r 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 proliferative response of T lymphocytes were significan tly (p<0.001) lower, while the number and phagocyting capacity of monocytes were significantly (p<0,001) higher in all patients before therapy, in com parison to the controls. After RT, the T cell number and proliferative resp onse were significantly (p<0.001) decreased, while the number of monocytes and their phagocyting capacity remained unchanged, when compared to the pre treatment values. Unlike RT, chemotherapy did not change any investigated p arameter, except for the phagocyting activity of monocytes, which was signi ficantly (p<0.02) decreased, in comparison to the pretreatment value, after four cycles of ChT only. Conclusions. Two cancer treatment modalities - radio- and chemotherapy - va riably affect the immune status of lung cancer patients. The initial great disturbances of general immunity parameters are further aggravated by radio therapy. Unlike RT, chemotherapy exerts no suppression at all; on the contr ary, it tends to normalize some of the parameters of cellular immunity of l ung cancer patients.