放疗联合顺铂-多西他赛或顺铂-氟尿嘧啶治疗中晚期食管癌临床评价

Clinical Evaluation on Radiotherapy Combined with Cisplatin-Docetaxel or Cisplatin-Fluorouracil in the Treatment of Advanced Esophageal Cancer

目的探讨顺铂-多西他赛与顺铂-氟尿嘧啶分别联合放射治疗(简称放疗)中晚期食管癌的疗效及对血清鳞状细胞癌相关抗原(SCCA)的影响。方法选取黄山首康医院2014年1月至2016年9月收治的食管癌患者80例,按随机数字表法分为对照组和观察组,各40例。所有患者均进行放疗,对照组同时采用顺铂-氟尿嘧啶化学治疗(简称化疗)方案治疗,观察组采用顺铂-多西他赛化疗方案治疗。结果观察组临床疗效为92.50%,明显高于对照组的75.00%(χ^2=4.501,P=0.034);治疗后,两组患者SCCA水平均下降,且观察组明显低于对照组(P<0.05);治疗后,两组患者的CD3^+,CD4^+,CD4^+/CD8^+水平出现不同程度下降,CD8^+出现不同程度上升,且观察组改善程度明显优于对照组(P<0.05);观察组不良反应发生率为17.50%,明显低于对照组40.00%(χ^2=4.943,P=0.026<0.05)。结论顺铂-多西他赛作为中晚期食管癌患者放疗时的同步化疗方案,临床效果优于顺铂-氟尿嘧啶的化疗方案,且对免疫功能影响小,安全可靠。

Objective To investigate the clinical effect of cisplatin-docetaxel or cisplatin-fluorouracil combined with radiotherapy in the treatment of advanced esophageal cancer and their effects on serum squamous cell carcinoma antigen(SCCA).Methods Totally 80 patients with esophageal cancer admitted to Huangshan Shoukang Hospital from January 2014 to September 2016 were selected and divided into the control group and the observation group according to the random number table method,40 cases in each group.All patients underwent radiotherapy,the patients in the control group received cisplatin-fluorouracil chemotherapy regimen,while the patients in the observation group received cisplatin-docetaxel chemotherapy regimen.Results The clinical effective rate of the observation group was 92.50%,which was significantly higher than 75.00%of the control group(χ^2=4.501,P=0.034).After treatment,the levels of SCCA in the two groups were decreased,and that in the observation group was significantly lower than that in the control group(P<0.05).After treatment,the levels of CD3^+,CD4^+,CD4^+/CD8^+in the two groups were decreased in varying degrees,while the levels of CD8^+in the two groups were increased in varying degrees,and the improvement in the observation group was significantly better than that in the control group(P<0.05).The incidence rate of adverse reactions in the observation group was 17.50%,which was significantly lower than 40.00%in the control group(χ^2=4.943,P=0.026 0.05).Conclusion As a concurrent chemotherapy regimen for patients with advanced esophageal cancer during radiotherapy,the clinical effect of cisplatin-docetaxel is better than cisplatin-fluorouracil.It has little effect on immune function,and it is safe and reliable.