不同放疗方案联合TP方案对中晚期食管癌患者生存期及生活质量的影响

Effects of Different Radiotherapy Regimens Combined with TP Regimen on the Survival and Quality of Life of Patients with Middle and Advanced Esophageal Cancer

目的探讨不同放疗方案联合TP方案对中晚期食管癌患者生存期及生活质量的影响。方法选取在我院接受治疗的中晚期食管癌患者110例,采用随机数表法分为观察组和对照组,各55例。对照组给予常规放疗+TP方案治疗,观察组给予调强放疗+TP方案治疗。比较两组患者的临床疗效,记录两组患者治疗前和治疗后的一般状况评分(KPS评分)、生活质量评分(QOL评分)以及肝肾功能指标丙氨酸转氨酶(ALT)、谷草转氨酶(AST)、肌酐(Cr)、血尿素氮(BUN)水平,比较两组患者的1年、3年生存率,记录两组患者白细胞减少、呕吐、食管狭窄、食管炎、放射性肺炎等不良反应的发生情况。结果治疗1年后,观察组总有效率为95.56%,显著高于对照组(77.27%),差异有统计学意义(P<0.05)。治疗后,两组患者KPS和QOL评分均较治疗前提高,且观察组均显著高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者ALT、AST、Cr、BUN表达水平均较治疗前降低,且观察组显著低于对照组,差异有统计学意义(P<0.05)。观察组1年、3年生存率分别为89.09%、76.36%,对照组分别为72.73%、61.81%,观察组生存率显著高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为10.91%,对照组为25.45%,差异有统计学意义(P<0.05)。结论对中晚期食管癌患者采用调强放疗+TP方案治疗,可缓解其临床症状,减轻肝肾功能损伤,延长生存期,提高生活质量,临床疗效显著。

Objective To investigate the effects of different radiotherapy regimens combined with TP regimen on the survival and quality of life of patients with middle and advanced esophageal cancer. Methods The selected 110 patients with advanced esophageal cancer in our hospital were randomly divided into the observation group(n=55) and control group(n=55). The control group was treated with routine radiotherapy +TP regimen, and the observation group was given intensity modulated radiotherapy(IMRT) + TP regimen. The clinical effect of patients, scores of the general condition(KPS score) and quality of life(QOL score) were recorded before and after treatment. The liver and kidney function indexes like alanine aminotransferase(ALT) and aspartate aminotransferase(AST), creatinine(Cr), blood urea nitrogen(BUN) changes were detected out. The 1-year and 3-year survival rate, the incidence of adverse reactions like leucopenia, vomiting, esophageal stenosis, esophagitis and pneumonitis were observed and compared. Results After treatment, the total effective rate of observation group was 95.56%, higher than that of the control group(77.27%)(P<0.05). The KPS and QOL scores were increased when compared with before treatment. And the observation group had higher KPS and QOL scores than the control group(P<0.05). The ALT, AST, Cr and BUN levels were decreased after treatment, and the above levels of observation group were significantly lower than those of the control group(P<0.05). The 1-year and 3-year survival rate of the observation group was 89.09% and 76.36% respectively, both higher than that of the control group(respectively 72.73% and 61.81%)(P<0.05). The total incidence rate of adverse reactions was 10.91% in observation group, but was 25.45% in control group(P<0.05). Conclusion TP regimen plus IMRT for middle and advanced esophageal cancer can relieve the clinical symptoms, regulate liver and kidney function, prolong the survival time and improve the quality of life of patients.