调强放疗与顺铂和紫杉醇化疗方案联合治疗食管癌的临床研究

Clinical study of intensity modulated radiotherapy combined with UT regimen in the treatment of esophageal cancer

目的探讨调强放疗与顺铂及紫杉醇(UT)化疗方案联合治疗食管癌的临床效果以及对相关细胞因子水平的影响,为食管癌的临床治疗提供新方案。方法选取40例接受UT化疗方案与普通放疗治疗的食管癌患者作为对照组,选取40例接受调强放疗与UT化疗方案联合治疗的食管癌患者作为观察组。治疗后观察两组患者临床治疗效果、3年内生存率以及临床不良反应,通过酶联免疫吸附法测定两组患者治疗前后细胞因子水平变化。结果联合治疗后观察组食管癌患者有效率和生存率均高于治疗后对照组(P<0.05)。观察组患者放射性肺炎、放射性食管炎、骨髓抑制、恶心呕吐、肝功能异常和皮肤反应发生率低于对照组(P<0.05)。与治疗前相比,食管癌患者治疗后细胞因子C反应蛋白(CRP)、白细胞介素(IL)-6、IL-10和可溶性MHC-I分子链相关基因A(s MICA)水平降低(P<0.05);治疗后观察组细胞因子(CRP、s MICA、IL-6和IL-8)水平低于治疗后对照组(P<0.05)。结论调强放疗与UT化疗方案联合治疗能够提高食管癌临床治疗效果,延长患者生存时间,改善相关细胞因子水平。

Objective To observe the clinical effect of intensity modulated radiotherapy （IMRT） combined with UT regimen in the treatment of esophageal cancer, and analyze the impact on the level of cytokines, to establish a new scheme for clinical treatment of esophageal cancer. Method A total of 80 patients with esophageal cancer were included in the study, in which 40 cases were treated with UT regimen and routine radiotherapy （control group）, while another 40 cases were administered with IMRT combined with UT regimen （study group）. All patients were observed for the clinical therapeutic effect, 3-year survival rate and clinical adverse reactions after treatment, besides, the level of cytokines in the two groups before and after treatment were determined by enzyme linked immunosorbent assay. Result After treatment, the response rate and survival rate of study group were significantly higher than that of control group （P〈0.05）. The inci-dence of radiation pneumonitis, radiation esophagitis, bone marrow suppression, nausea and vomiting, abnormal liver function and skin reaction in the study group were lower than those in the control group （P〈0.05）. The level of C-reactive protein （CRP）, interleukin （IL）-6, IL-10 and soluble MHC-I chain related gene A （sMICA） in study group were decreased after treatment （P〈0.05）;and the levels of cytokines （CRP, sMICA, IL-6 and IL-8） in the study group after treatment were significantly lower than those in the control group （P〈0.05）. Conclusion Intensity modulated radiotherapy combined with UT regimen can improve the clinical treatment effect, prolong the survival time of patients with esophageal cancer, and may improve the level of related cytokines.