同步放化疗联合手术治疗肺上沟癌的效果观察

Observation on the effects of concurrent chemoradiotherapy combined with surgery on pancoast cancer

目的观察同步放化疗联合手术治疗肺上沟癌的效果。方法回顾性分析运城市中心医院2015年3月至2017年3月82例肺上沟癌患者临床资料,其中对照组41例行单纯行手术治疗,研究组41例术前同步放化疗联合手术治疗。比较两组患者手术情况、近期临床疗效、血清肿瘤标志物水平、术后并发症与放化疗不良反应情况。结果研究组手术彻底切除率高于对照组(P<0.05),手术时间长于对照组(P<0.05),术中出血量多于对照组(P<0.05)。治疗后,研究组疼痛缓解率、1年生存率与QOL评分均高于对照组(P<0.05)。术后,两组术后并发症比较差异未见统计学意义(P>0.05)。术后1周,两组血清肿瘤标志物[糖类抗原125(CA125)、糖类抗原15-3(CA15-3)与神经元特异性烯醇化酶(NSE)]水平均降低,且研究组降低幅度更大(P<0.05);治疗期间,对照组无放化疗不良反应,研究组出现不同程度放化疗反应。结论肺上沟癌患者术前同步放化疗后有助于提高手术彻底切除率与近期疗效,改善患者生存状况与预后,值得临床推广。

Objective To observe the application effects of concurrent chemoradiotherapy combined with surgery on pancoast cancer.Methods The clinical data of 82 patients with pancoast cancer in Yuncheng Central Hospital from March 2015 to March 2017 were retrospectively analyzed,including 41 cases only with surgery(control group)and 41 cases with preoperative concurrent chemoradiotherapy and surgery(study group).The surgery conditions,short-term clinical efficacy,serum tumor markers levels,postoperative complications and adverse chemoradiotherapy reactions were compared between the two groups.Results After operation,the complete resection rate in study group was higher than that in control group(P<0.05),the operative time was significantly longer than that in control group(P<0.05),and the intraoperative blood loss was significantly higher than that in control group(P<0.05).After treatment,the pain relief rate,1-year survival rate and quality of life score in study group were higher than those in control group(P<0.05).After operation,there was no significant difference in postoperative complications between the two groups(P>0.05).At 1 week after operation,the levels of serum tumor markers,such as carbohydrate antigen 125(CA125),carbohydrate antigen 15-3(CA15-3)and neuron-specific enolase(NSE)were significantly decreased in the two groups,and the decreases were larger in study group(P<0.05).During treatment,there were no adverse chemoradiotherapy reactions in control group,however,there were different degrees of chemoradiotherapy reactions in study group.Conclusions Preoperative concurrent chemoradiotherapy for patients with pancoast cancer can improve the complete resection rate and short-term efficacy,and promote the survival status and prognosis.So it is worthy of clinical promotion.