同步放化疗联合热疗对局部进展期宫颈癌患者血清血管内皮生长因子表达及预后的影响

Effect of concurrent chemoradiotherapy combined with thermotherapy on serum vascular endothelial growth factor expression and prognosis in patients with locally advanced cervical cancer

目的观察同步放化疗联合热疗对局部进展期宫颈癌患者血清血管内皮生长因子(VEGF)表达及预后的影响。方法将128例ⅡB~ⅣA期局部进展期宫颈癌患者随机分为研究组及对照组,每组64例。对照组给予同步放化疗治疗,研究组给予同步放化疗联合热疗治疗。比较两组患者血清VEGF的表达情况、不良反应及3年总生存率。结果两组的血清VEGF水平比较,差异有统计学意义(P<0.05),两组的血清VEGF水平均有随时间变化的趋势(P<0.05),分组与时间有交互效应(P<0.05)。研究组白细胞降低、放射性膀胱炎及放射性直肠炎发生率均低于对照组(P<0.05)。研究组3年总生存率高于对照组(P<0.05)。结论与单纯同步放化疗比较,同步放化疗联合热疗治疗局部进展期宫颈癌可明显降低患者血清VEGF水平,减轻患者不良反应,提高患者3年生存率。VEGF或可作为局部进展期宫颈癌预后的监测指标。

Objective To observe the effect of concurrent chemoradiotherapy combined with thermotherapy on the expression of serum vascular endothelial growth factor（ VEGF） and the prognosis in patients with locally advanced cervical cancer. Methods A total of128 patients with stage ⅡB to ⅣA locally advanced cervical cancer were randomly divided into study group and control group,with 64 cases in each group. The control group was treated with concurrent chemoradiotherapy,and the study group with concurrent chemoradiotherapy plus thermotherapy. The serum VEGF expression,incidence of adverse reactions,and 3-year overall survival rate were compared between the two groups. Results Statistically significant difference was observed in the serum VEGF level between the two groups（ P 0. 05）,serum VEGF level presented a tendency to change with time in both groups（ P 0. 05）,and there was an interaction effect between group and time（ P 0. 05）. The study group had lower incidence rates of leukopenia,radiocystitis and radiation proctitis compared to the control group（ P 0. 05）. The 3-year overall survival rate of the study group was higher than that of the control group（ P 0. 05）. Conclusion Compared to simplex concurrent chemoradiotherapy,concurrent chemoradiotherapy combined with thermotherapy can significantly reduce the serum VEGF level,alleviate adverse reactions and increase the 3-year survival rate for the treatment of patients with locally advanced cervical cancer. VEGF might act as a monitoring indicator for the prognosis of locally advanced cervical cancer.