奈达铂联合多西他赛并同期放疗治疗不可手术食管癌的疗效
|
摘要
目的探讨奈达铂联合多西他赛并同期放疗治疗不可手术食管癌的临床治疗效果。方法选取自2014年7月至2015年12月在肿瘤科接受治疗的中晚期食管癌确诊患者93例作为研究对象,采用随机数字表法将所有研究对象分为观察组和对照组。对照组给予顺铂联合5-氟尿嘧啶化疗和同步放射治疗,观察组给予奈达铂联合多西他赛化疗以及与对照组同等的同步放射治疗。比较2组患者血清p53抗体、鳞状细胞癌抗原(SCCAg)、癌胚抗原(CEA)水平,临床疗效,以及治疗后2年累计生存率。结果治疗后2组患者血清p53抗体、SCCAg和CEA水平均显著低于治疗前,观察组患者血清p53抗体、SCCAg和CEA水平均显著低于对照组,且以上差异均有统计学意义(P<0.05);观察组患者治疗总有效率明显高于对照组,且差异具有统计学意义(χ~2=4.658,P<0.05);治疗后观察组食管癌患者的2年累计生存率显著高于对照组,且差异有统计学意义(53.33%vs 27.08%, Log-rank χ~2=4.532,P<0.05)。结论奈达铂联合多西他赛并同期放疗治疗不可手术食管癌的临床治疗效果较好,且预后也较好,值得在临床推广应用。
AIM To investigate the clinical efficacy of nedaplatin combined with docetaxel and concurrent radiotherapy in the treatment of unresectable esophageal cancer. METHODS Totally 93 patients with advanced esophageal cancer who were treated in the oncology department of our hospital from July 2014 to December 2015 were selected as the research subjects. All the subjects were divided into the observation group and the control group by the random number table method. The control group was treated with cisplatin combined with 5-fluorouracil chemotherapy and synchrotron radiation therapy. The observation group was treated with nedaplatin combined with docetaxel chemotherapy and the control group with the same synchrotron radiation therapy. The serum levels of p53 antibody, squamous cell carcinoma antigen(SCCAg) and carcinoembryonic antigen(CEA), clinical efficacy and 2-year cumulative survival rate were compared between 2 groups. RESULTS After treatment, the serum levels of p53, SCCAg and CEA in 2 groups were significantly lower than those before treatment, and the levels of serum p53 antibody, SCCAg and CEA in the observation group were significantly lower than those in the control group(P<0.05). The total effective rate of the patients in the observation group was significantly higher than that in the control group(χ~2=4.658, P<0.05), and the difference was statistically significant(P<0.05). The 2-year cumulative survival rate(53.33% vs 27.08%, Log-rank χ~2=4.532, P<0.05) in the patients with esophageal cancer was significantly higher than that in the control group after treatment, and there was a statistically significant difference(P<0.05). CONCLUSION Nedaplatin combined with docetaxel and concurrent radiotherapy in the treatment of unresectable esophageal cancer is effective and has a good prognosis. It is worthy of clinical application.
AIM To investigate the clinical efficacy of nedaplatin combined with docetaxel and concurrent radiotherapy in the treatment of unresectable esophageal cancer. METHODS Totally 93 patients with advanced esophageal cancer who were treated in the oncology department of our hospital from July 2014 to December 2015 were selected as the research subjects. All the subjects were divided into the observation group and the control group by the random number table method. The control group was treated with cisplatin combined with 5-fluorouracil chemotherapy and synchrotron radiation therapy. The observation group was treated with nedaplatin combined with docetaxel chemotherapy and the control group with the same synchrotron radiation therapy. The serum levels of p53 antibody, squamous cell carcinoma antigen(SCCAg) and carcinoembryonic antigen(CEA), clinical efficacy and 2-year cumulative survival rate were compared between 2 groups. RESULTS After treatment, the serum levels of p53, SCCAg and CEA in 2 groups were significantly lower than those before treatment, and the levels of serum p53 antibody, SCCAg and CEA in the observation group were significantly lower than those in the control group(P<0.05). The total effective rate of the patients in the observation group was significantly higher than that in the control group(χ~2=4.658, P<0.05), and the difference was statistically significant(P<0.05). The 2-year cumulative survival rate(53.33% vs 27.08%, Log-rank χ~2=4.532, P<0.05) in the patients with esophageal cancer was significantly higher than that in the control group after treatment, and there was a statistically significant difference(P<0.05). CONCLUSION Nedaplatin combined with docetaxel and concurrent radiotherapy in the treatment of unresectable esophageal cancer is effective and has a good prognosis. It is worthy of clinical application.
引文
[1] 曹小琴,孙喜斌.食管癌发病水平及变化趋势[J].中国肿瘤临床,2016,43(21):932.
[2] 白卫哲,谭家驹.食管癌发生发展的相关因素最新研究进展[J].中外医学研究,2013,11(10):154.
[3] 王付湘.奈达铂联合多西他赛并同期放疗治疗不可手术食管癌的临床效果观察[J].中国当代医药,2014,21(36):89.
[4] 姜金栋.奈达铂联合多西他赛并同期放疗治疗不可手术食管癌的疗效及毒副反应分析[J].中国医药科学,2013,3(17):107.
[5] 柯柳杨,黄白云.放疗联合多西他赛+奈达铂(DN)或顺铂+氟尿嘧啶(PF)方案治疗局部晚期食管癌的临床分析[J].中国医药指南,2013,15(23):13.
[6] 李紫琼,赫晓磊,苟丽,等.食管癌患者血清P53抗体水平变化及其临床意义[J].新疆医学,2017,47(1):63.
[7] EGASHIRA A,MORITA M,YOSHIDA R,et al.Loss of p53 in esophageal squamous cell carcinoma and the correlation with survival:analyses of gene mutations,protein expression,and loss of heterozygosity in Japanese patients[J].J Surg Oncol,2011,104(2):169.
[8] 周保平,李维春,周彩云.食管癌中p53过表达、nm23低表达及其与预后的关系[J].安徽卫生职业技术学院学报,2013,12(2):83.
[9] 周国华,姚维深,莫春生.P53、CD44v6和CD24在食管鳞癌中的表达及意义[J].白求恩医学杂志,2014,12(2):132.
[10] 尚丽,李淑红,杜琳娜,等.SIRT-3表达水平与食管癌患者预后关系[J].河北医科大学学报,2013,34(8):899.
[11] 王政书.食管癌患者血清SCCAg 的检测及临床意义[J].国际检验医学杂志,2015,36(24):3643.
[12] GUO T,NG K K,CHIANG H W,et al.Duodenal neuroendocrine carcinoma presenting with disseminated liver and bone metastases as the primary manifestation:case report and literature review[J].Cell Biochem Biophys,2015,72(1):305.
[13] 董芸,吴国华,韩增伟,等.SCC、CYFRA21-1联检对食管癌的诊断价值以及对放疗疗效评估[J].放射免疫学杂志,2011,24(4):387.
[14] 杜兰宁,邰霄辉,王丽娜,等.食管癌患者放疗前后血清癌胚抗原和细胞角蛋白19片段水平变化及临床意义[J].兰州大学学报(医学版),2014,40(2):63.
[15] 杜军华,乔洪源,尹宜发.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137.
[2] 白卫哲,谭家驹.食管癌发生发展的相关因素最新研究进展[J].中外医学研究,2013,11(10):154.
[3] 王付湘.奈达铂联合多西他赛并同期放疗治疗不可手术食管癌的临床效果观察[J].中国当代医药,2014,21(36):89.
[4] 姜金栋.奈达铂联合多西他赛并同期放疗治疗不可手术食管癌的疗效及毒副反应分析[J].中国医药科学,2013,3(17):107.
[5] 柯柳杨,黄白云.放疗联合多西他赛+奈达铂(DN)或顺铂+氟尿嘧啶(PF)方案治疗局部晚期食管癌的临床分析[J].中国医药指南,2013,15(23):13.
[6] 李紫琼,赫晓磊,苟丽,等.食管癌患者血清P53抗体水平变化及其临床意义[J].新疆医学,2017,47(1):63.
[7] EGASHIRA A,MORITA M,YOSHIDA R,et al.Loss of p53 in esophageal squamous cell carcinoma and the correlation with survival:analyses of gene mutations,protein expression,and loss of heterozygosity in Japanese patients[J].J Surg Oncol,2011,104(2):169.
[8] 周保平,李维春,周彩云.食管癌中p53过表达、nm23低表达及其与预后的关系[J].安徽卫生职业技术学院学报,2013,12(2):83.
[9] 周国华,姚维深,莫春生.P53、CD44v6和CD24在食管鳞癌中的表达及意义[J].白求恩医学杂志,2014,12(2):132.
[10] 尚丽,李淑红,杜琳娜,等.SIRT-3表达水平与食管癌患者预后关系[J].河北医科大学学报,2013,34(8):899.
[11] 王政书.食管癌患者血清SCCAg 的检测及临床意义[J].国际检验医学杂志,2015,36(24):3643.
[12] GUO T,NG K K,CHIANG H W,et al.Duodenal neuroendocrine carcinoma presenting with disseminated liver and bone metastases as the primary manifestation:case report and literature review[J].Cell Biochem Biophys,2015,72(1):305.
[13] 董芸,吴国华,韩增伟,等.SCC、CYFRA21-1联检对食管癌的诊断价值以及对放疗疗效评估[J].放射免疫学杂志,2011,24(4):387.
[14] 杜兰宁,邰霄辉,王丽娜,等.食管癌患者放疗前后血清癌胚抗原和细胞角蛋白19片段水平变化及临床意义[J].兰州大学学报(医学版),2014,40(2):63.
[15] 杜军华,乔洪源,尹宜发.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137.