动脉灌注化疗联合放射治疗中晚期食道癌血清标记物及生存率的影响
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摘要
[目的]研究动脉灌注化疗联合放射治疗中晚期食管癌的临床疗效及对患者血清肿瘤标记物及生存率的影响。[方法]选择来我院住院治疗的82例中晚期食管癌患者并将其随机分为观察组42例和对照组40例,2组均给予放射治疗,观察组在此基础上给予介入化疗,观察和比较2组的临床治疗效果,治疗前后血清癌抗原125(cancer antigen 125,CA125)、癌胚抗原(carcinoembryonic antigen,CEA)、人糖连抗原199(Carbohydrate antigen199,CAl9-9)和鳞状细胞癌相关抗原(squamous cell carcinoma antigen,SCC)水平的变化及1、2、3年的生存率情况。[结果]治疗后,观察组完全缓解率和总缓解率均明显高于对照组(P<0.05)。观察组治疗后1、2和3个月的血清CEA、CA125、CA199和SCC水平均显著低于对照组(P<0.05),生存率明显高于对照组(58.62%34.78%,41.37%26.08%,20.69%17.39%,χ~2=2.9199,1.3253,0.0898,P>0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。[结论]动脉灌注化疗联合放射治疗中晚期食道癌的临床疗效明显优于单纯放射治疗,能有效的改善患者的血清肿瘤标记物水平,提高患者的生存率,并且不会明显增加患者的不良反应。
[Objective]To investigate clinical efficiency of combined intervention chemotherapy and radiotherapy in treating advanced esophageal carcinoma,and its influence on serum tumor marker as well as survival rate.[Methods]A total of 82 cases with advanced esophageal carcinoma admitted in our hospital were selected and divided into observation group(42 cases)and control group(40 cases).Both of the groups received radiotherapy,while the observation group received intervention chemotherapy on that basis.The clinical effects of two groups were observed and compared;including change of serum CEA,CA125,CA199 and SCC levels,and survival rates of two groups 1,2 and 3 years after treatment.[Results]After treatment,the complete and total emission rates in observation group were all higher than that in control group(P<0.05);the serum CEA,CA125,CA199 and SCC levels in observation group 1,2 and 3 months after treatment respectively were 56.75%,48.65%,35.13%,which were significantly higher than that of control group(P<0.05);the survival rates in observation group(56.75%,48.65%and 35.13%)were significantly higher than that of control group(58.62% vs.34.78%,41.37% vs.26.08%,20.69% vs.17.39%χ2=2.9199,1.3253,0.0898,P>0.05).The comparative difference between two groups in adverse reaction was not statistically significant(P>0.05).[Conclusion]The application of intervention chemotherapy to advanced esophageal carcinoma can improve clinical effect and enhance level of serum tumor marker;it contributes to increase patients' survival rate.
[Objective]To investigate clinical efficiency of combined intervention chemotherapy and radiotherapy in treating advanced esophageal carcinoma,and its influence on serum tumor marker as well as survival rate.[Methods]A total of 82 cases with advanced esophageal carcinoma admitted in our hospital were selected and divided into observation group(42 cases)and control group(40 cases).Both of the groups received radiotherapy,while the observation group received intervention chemotherapy on that basis.The clinical effects of two groups were observed and compared;including change of serum CEA,CA125,CA199 and SCC levels,and survival rates of two groups 1,2 and 3 years after treatment.[Results]After treatment,the complete and total emission rates in observation group were all higher than that in control group(P<0.05);the serum CEA,CA125,CA199 and SCC levels in observation group 1,2 and 3 months after treatment respectively were 56.75%,48.65%,35.13%,which were significantly higher than that of control group(P<0.05);the survival rates in observation group(56.75%,48.65%and 35.13%)were significantly higher than that of control group(58.62% vs.34.78%,41.37% vs.26.08%,20.69% vs.17.39%χ2=2.9199,1.3253,0.0898,P>0.05).The comparative difference between two groups in adverse reaction was not statistically significant(P>0.05).[Conclusion]The application of intervention chemotherapy to advanced esophageal carcinoma can improve clinical effect and enhance level of serum tumor marker;it contributes to increase patients' survival rate.
引文
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[11]Berger B,Stahlberg K,Lemminger A,et al.Impact of radiotherapy,chemotherapy and surgery in multimodal treatment of locally advanced esophageal cancer.[J].Oncology,2011,81(5-6):387-394.
[12]朱磊,段巧虹,范平生,等.靶动脉灌注维拉帕米对晚期食管癌介入疗效的临床观察[J].安徽医学,2011,32(11):1821-1824.
[13]Scarpa M,Noaro G,Saadeh L,et al.Esophageal cancer management:preoperative CA19.9and CEA serum levels may identify occult advanced adenocarcinoma[J].World J Surg,2015,39(2):424-432.
[14]Thomas D S,Fourkala E,Apostolidou S,et al.Evaluation of serum CEA,CYFRA21-1and CA125for the early detection of colorectal cancer using longitudinal preclinical samples[J].British J Cancer,2015,113(2):268-274.
[15]智玲玲,原园,李志英.新辅助化疗联合手术对老年食管癌患者CEA、CA199和CA125的影响[J].实用癌症杂志,2017,32(2):224-226.
[16]屈中玉,万里新.多项肿瘤标志物联合检测在食管癌复发中的诊断意义[J].现代预防医学,2011,38(3):592-593.
[17]申景涛,施鸣,辛小燕,等.食管癌放疗前后血清肿瘤标志物CEA、SCC和CYFRA21-1水平的变化分析[J].标记免疫分析与临床,2016,23(11):1251-1253.
[18]周莹,张志强.食管癌的防治进展[J].中国中西医结合消化杂志,2016,24(4):321-324.
[2]Krishnamoorthi R,Borah B,Heien H,et al.Rates and predictors of progression to esophageal carcinoma in a large population-based Barrett’s esophagus cohort[J].Gastrointestinal Endoscopy,2016,84(1):40-46.
[3]姜志勇,刘福建,关航.超声内镜在食管癌术前TNM分期中的应用价值分析[J].中国实验诊断学,2015(1):104-106.
[4]Zhang W Z,Chen,J Z,Li D R,et.al.Simultaneous modulated accelerated radiation therapy for esophageal cancer:A feasibility study[J].World J Gastroenterol,2014,20(38):13973-13980.
[5]Pfau,P R,Pham H,Ellis R,et al.,et al.A novel use of endoscopic clips in the treatment planning for radiation therapy(XRT)for esophageal cancer[J].J Clin Gastroenterol,2015,39(5):372-375.
[6]冯慧,王华,张晓彦,等.华蟾素注射液辅助西妥昔单抗注射液交替化疗对胸段食管癌淋巴结转移患者的疗效及安全性评估[J].肿瘤药学,2017,7(1):93-98.
[7]Pasquali S,Yim G,Vohra R S,et al.Survival After Neoadjuvant and Adjuvant Treatments Compared to Surgery Alone for Resectable Esophageal Carcinoma:A Network Meta-analysis[J].Ann Surg,2017,265(3):481-491.
[8]纪红娟.自拟肺癌方加减联合TP方案治疗中晚期非小细胞肺癌患者的疗效观察[J].云南中医中药杂志,2015,36(6):34-35.
[9]Tsuchida E.Analysis of factors influencing local control of esophageal carcinoma treated by radiotherapy.[J].Biocell:official journal of the Sociedades Latinoamericanas de Microscopía Electronica.et.al,2011,33(3):149-154.
[10]Gani C,Fischer S G,Zips D.Correlation of locoregional treatment failures with radiotherapy target volumes after radiochemotherapy for esophageal cancer[J].J Clin Oncol,2016,34(4suppl):166-166.
[11]Berger B,Stahlberg K,Lemminger A,et al.Impact of radiotherapy,chemotherapy and surgery in multimodal treatment of locally advanced esophageal cancer.[J].Oncology,2011,81(5-6):387-394.
[12]朱磊,段巧虹,范平生,等.靶动脉灌注维拉帕米对晚期食管癌介入疗效的临床观察[J].安徽医学,2011,32(11):1821-1824.
[13]Scarpa M,Noaro G,Saadeh L,et al.Esophageal cancer management:preoperative CA19.9and CEA serum levels may identify occult advanced adenocarcinoma[J].World J Surg,2015,39(2):424-432.
[14]Thomas D S,Fourkala E,Apostolidou S,et al.Evaluation of serum CEA,CYFRA21-1and CA125for the early detection of colorectal cancer using longitudinal preclinical samples[J].British J Cancer,2015,113(2):268-274.
[15]智玲玲,原园,李志英.新辅助化疗联合手术对老年食管癌患者CEA、CA199和CA125的影响[J].实用癌症杂志,2017,32(2):224-226.
[16]屈中玉,万里新.多项肿瘤标志物联合检测在食管癌复发中的诊断意义[J].现代预防医学,2011,38(3):592-593.
[17]申景涛,施鸣,辛小燕,等.食管癌放疗前后血清肿瘤标志物CEA、SCC和CYFRA21-1水平的变化分析[J].标记免疫分析与临床,2016,23(11):1251-1253.
[18]周莹,张志强.食管癌的防治进展[J].中国中西医结合消化杂志,2016,24(4):321-324.