同步加量调强放疗联合XELOX化疗对局部进展期直肠癌患者术后复发率及血清癌胚抗原水平的影响

Effect of Concurrent dose Intensity Modulated Radiotherapy Combined with XELOX Chemotherapy on Postoperative Recurrence Rate and Serum Carcinoembryonic Antigen Level in Locally Advanced Rectal Cancer Patients

目的分析同步加量调强放疗联合XELOX化疗方案对局部进展期直肠癌患者术后复发率及血清癌胚抗原(CEA)水平的影响。方法选取2014年9月-2016年6月河南省商丘市第一人民医院局部进展期直肠癌患者78例,依照化疗方案不同分组。对照组39例行XELOX化疗方案,观察组39例行同步加量调强放疗联合XELOX化疗方案。观察比较两组保肛率、切缘无癌细胞切除率、毒副反应发生率及治疗前后肿瘤标志物[血清CEA、糖链抗原(CA19-9)]水平,并统计术后2年两组局部复发率、远处转移率、总生存率。结果治疗后观察组保肛率、切缘无癌细胞切除率高于对照组,组间差异显著(P<0.05);治疗后观察组血清CEA、CA19-9水平低于对照组,组间差异显著(P<0.05);两组术后2年观察组局部复发率、远处转移率比较无显著差异(P>0.05);术后2年观察组总生存率高于对照组,组间差异显著(P<0.05);术后两组毒副反应发生率比较无显著差异(P>0.05)。结论同步加量调强放疗联合XELOX化疗方案应用于局部进展期直肠癌,可有效保肛,提高切缘无癌细胞切除率,降低CEA、CA19-9水平,提高总生存率,安全性较高。

Objective To analyze the effect of concurrent dose intensity modulated radiotherapy combined with XELOX chemotherapy on postoperative recurrence rate and serum carcinoembryonic antigen (CEA) level in locally advanced rectal cancer patients.Methods 78 patients with locally advanced rectal cancer from September 2014 to June 2016 in the First People's Hospital of Shangqiu City,Henan Province were selected and divided into different groups according to chemotherapy regimens. 39 cases in control group received XELOX chemotherapy,while 39 cases in observation group received concurrent dose intensity modulated radiotherapy combined with XELOX chemotherapy.The anus-preserving rate,cancer cell-free resection rate,incidence of toxic and side effects and tumor markers (serum CEA,carbohydrate antigen (CA19-9)) levels before and after treatment were observed and compared between the two groups,and the local recurrence rate,distant metastasis rate and overall survival rate of the two groups 2 years after operation were counted.Results After treatment,the anus-preserving rate and cancer-free resection rate of the incisal margin in the observation group were higher than those in the control group,with significant differences between the groups (P < 0.05).After treatment,the levels of serum CEA and CA19-9 in the observation group were lower than those in the control group,with significant differences between the groups (P < 0.05).There was no significant difference in local recurrence rate and distant metastasis rate between the two groups 2 years after operation (P > 0.05).The overall survival rate of the observation group was higher than that of the control group 2 years after operation,with significant difference between the two groups (P < 0.05).There was no significant difference in the incidence of side effects between the two groups (P > 0.05).Conclusion Concurrent dose intensity modulated radiation therapy combined with XELOX chemotherapy can effectively preserve anus,improve the resection rate of cancer-free cells at the resection margin,reduce CEA and CA19-9 levels,improve the overall survival rate and have high safety when applied to locally advanced rectal cancer.