3D—CRT治疗晚期腹部肿瘤后CA19—9、CEA的临床观察

The clinical observation of CA19 -9、CEA in advanced abdominal cancer by 3D - CRT treatment

目的：探讨CA19—9、CEA在3D—CRT治疗晚期腹部肿瘤中的临床意义。方法：收集38例晚期腹部肿瘤患者，以三雏适形放疗技术进行治疗，单次剂量300～400cGy，共10-12次，每日照射一次或隔日一次，每周五次或每周三次，总剂量30～48Gy，在放疗前和放结束后进行CA19—9、CEA的相关评价。结果：近期疗效总有效率（CR＋PR＋SD）为63．2％，远期疗效3个月、6个月、12个月生存率分别为63．2％、39．5％和34．2％，死亡率分别为21％、23．7％和5．3％，中住生存期4个月；可评价CBR有效为28．9％，稳定为42．1％，疼痛缓解率为29％。治疗后CA19—9、CEA，下降率分别为44％（11／25）、52．4％（11／21），经统计学分析，治疗前后CA19—9、CEA的变化在三维适形治疗晚期腹部肿瘤中有差别（P〈0．05）。治疗后CA19—9升高和正常者的一年生存率分别为21％、13．2％。治疗过程中CA19—9升高和下降者的生存率分别为0％、23．7％。而治后CEA升高和正常者的一年生存率分别为15．8％、18．4％，治疗过程中CEA升高和下降者的生存率分别为5．3％、15．8％。结论：①三维适形放疗能相对地控制肿瘤进展，提高生存期，延缓死亡，提高生活质量，减少病人痛苦，缓解肿瘤侵袭加速。②CEA，CA-199是评价腹部肿瘤3D—CRT疗效预后和诊治指标。

Objective：To investigate the clinical significance of CA19- 9, CEA in the advanced stomach cancer by 3D- CRT treatment. Methods： 38 patients with advanced AB - cancer were treated with three dimensional conformsl radiation therapy. They received 300 -400 cGy A total of 108 - 12 times, once a day or every two days, five or three times for a week with the total dosage of 3000 - 4800 cGy. The treatment effect and short - term relevant factors were evaluated after radiotherapy. Results ： Results ： In curative effect, total effective rate （ CR ＋ PR ＋ SD） was 63.2% ; in long term effect, the survival rate of 3 m,6m, 12m were 63.2% ,39.5% and 34.2% respectively, death rate of them were 21% ,23.7% and 5.3 % respectively, MS -- life span was 4m ; the utility was 28. 9 %, the stabilization was 42.1% , the pain remission rate was 29 % ; After the treatment, the decline rates of CA19 - 9, CEA were 44% （ 11/25 ）, 52.4% （ 11/ 21 ） o By statistical analysis , the pre - treatment and post - treatment changes of CA19 -9,CEA had a significant difference（P 〈 0.05 ）. After the treatment , the one year survival rates of CA19 -9 increased and normal were 21% and 13.2% . In the course of treatment ,the one year survival rates of CA19 -9 increased and decreased were 0% ,23.7% o After the treatment , the one year survival rates of CEA increased and normal werel5.8% and 18.4%. In the eourse of treatment ,the one year survival rates of CEA increased and decreased were 5.3% and 15.8%. Conclusion：①Three dimensional conformsl radiation therapy can control the advancement of tumor, improve survival rate, delay the death,elevate the quality of life, lessen the pain of patients, and relieve invasive acceleration of tumor. ②CEA and CA19 -9 are index which estimate curative effect,prognosis,diagnosis and therapeutics for AB -tumor with 3D -CRT.