同步放化疗对转移性食管癌患者近远期疗效的影响

Effect of concurrent chemoradiotherapy on the short-term and long-term effects of patients with metastatic esophageal cancer

目的:探究同步放化疗对转移性食管癌患者近远期疗效的影响。方法:选取南通市肿瘤医院2013年6月-2016年6月收治的转移性食管鳞癌患者60例为研究对象,使用随机数字表法将其分为两组,各30例,分别予序贯放化疗(序贯组)和同步放化疗(同步组),比较两组近期疗效,半年、1年、2年生存率,不良反应发生率,治疗前后肿瘤标志物水平及肿瘤侵袭转移相关指标。结果:治疗前,两组患者细胞角蛋白19片段抗原21-1(cytokeratin 19 fragment antigen21-1,CYFRA21-1)、鳞状细胞癌抗原(squamous cell carcinoma antigen, SCC-Ag)、微血管密度(micro vascular density, MVD)水平,血管内皮生长因子(vascular endothelial growth factor, VEGF)阳性率及基质金属蛋白酶-2(matrix metalloproteinase-2, MMP-2)阳性率比较差异均无统计学意义(均P>0.05)。治疗后,两组半年生存期差异无统计学意义(P>0.05);同步组治疗有效率及1、2年生存率显著高于序贯组(P<0.05);同步组CYFRA21-1、SCC-Ag、MVD水平,VEGF阳性率及MMP-2阳性率均显著低于序贯组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论:相较序贯放化疗,同步放化疗能有效提高转移性食管癌患者近期疗效,提高2年内存活率,抑制患者肿瘤侵袭能力且不增加不良反应,具有较好安全性,值得临床推广。

Objective : To investigate the effect of concurrent chemoradiotherapy on the short-term and long-term effects of patients with metastatic esophageal cancer. Methods : Sixty patients with metastatic esophageal squamous cell carcinoma admitted to our hospital from June 2013 to June 2016 were randomly divided into a sequential group(30 cases) and a synchronous group(30 cases). Sequential group received sequential chemoradiotherapy, synchronous group received concurrent chemoradiotherapy, compare the therapeutic effects of the two groups, half-year, 1-year, 2-years survival rate, incidence of adverse reactions and tumor marker levels before and after treatment and tumor Invasion transfer related indicators. Results : Before treatment, there was no significant difference in the levels of the cytokeratin 19 fragment antigen 21-1(CYFRA21-1), squamous cell carcinoma antigen(SCC-Ag), microvascular density(MVD), vascular endothelial growth factor(VEGF) positiverate and matrix metalloproteinase-2(MMP-2) positive rate between the two groups(P>0.05). After treatment, the difference of half-year survival between the two groups was not significant(P>0.05);the effective rate of the synchronous group and the 1-, 2-year survival rates were significantly higher than the sequential group;the synchronous group CYFRA21-1, SCC-Ag levels The MVD level, VEGF positive rate and MMP-2 positive rate were significantly lower than the sequential group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion : Compared with sequential chemoradiotherapy, concurrent chemoradiotherapy can effectively improve the short-term therapeutic effect of patients with metastatic esophageal cancer, improve the survival rate within 2 years, inhibit the tumor invasion ability and increase the adverse reactions, and have better safety. It is worthy of clinical promotion.