同步放化疗联合重组人血管内皮抑制素对中晚期宫颈癌的疗效和安全性分析

Analysis of the efficacy and safety of concurrent chemoradiotherapy combined with recombinant human endostatin in the treatment of advanced cervical cancer

目的探讨同步放化疗联合重组人血管内皮抑制素对中晚期宫颈癌的疗效和安全性。方法回顾性分析2015年1月至2017年5月新疆医科大学第一附属医院收治的164例中晚期宫颈癌患者的临床资料,将其中行同步放化疗的86例患者纳入对照组,行同步放化疗联合重组人血管内皮抑制素治疗的78例患者纳入观察组,比较两组患者近期、远期疗效和不良反应发生情况。结果观察组患者治疗总有效率显著高于对照组(P<0.05),两组患者不良反应发生率比较差异均无统计学意义(均P>0.05)。治疗后,两组患者CD3^+T细胞、CD4^+T细胞、自然杀伤细胞(natural killer cell,NK细胞)占比、CD4^+T细胞/CD8^+T细胞比值和血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、癌胚抗原相关细胞黏附因子6(carcinoembryonic antigen-related cell adhesion molecule 6,CEACAM6)水平均显著低于本组治疗前(均P<0.05),但观察组患者CD3^+T细胞、CD4^+T细胞、NK细胞占比和CD4^+T细胞/CD8^+T细胞比值均显著高于对照组(均P<0.05),血清VEGF、CEACAM6水平均显著低于对照组(均P<0.05)。两组患者1年生存率比较差异无统计学意义(P>0.05),但观察组患者2年生存率显著高于对照组(P<0.05)。结论同步放化疗联合重组人血管内皮抑制素能够下调中晚期宫颈癌患者血清VEGF、CEACAM6的表达,抑制肿瘤进展,保护机体免疫功能,延长患者生存期,且安全性较好。

Objective To explore the efficacy and safety of concurrent chemoradiotherapy combined with recombinant human endostatin in the treatment of advanced cervical cancer.Method A retrospective analysis was performed on 164 patients with advanced cervical cancer from January 2015 to May 2017 in the First Affiliated Hospital of Xinjiang Medical University.Among them,86 patients underwent concurrent chemoradiotherapy were included in control group,and 78 patients underwent concurrent chemoradiotherapy combined with recombinant human endostatin were included in observation group,the short-term and long-term efficacy and adverse reactions were compared between the two groups.Result The total effective rate of observation group was significantly higher than that of control group(all P<0.05),there were no significant difference in the incidence of adverse reactions between the two groups(all P<0.05).After treatment,the percentage of CD3+T cells,CD4+T cells,natural killer cells(NK cells),the CD4+T cells/CD8+T cells ratio and the levels of serum vascular endothelial growth factor(VEGF)and carcinoembryonic antigen-related cell adhesion molecule 6(CEACAM6)in the two groups were significantly lower than those before treatment(all P<0.05).However,the percentage of CD3+T cells,CD4+T cells,NK cells and the CD4+T cells/CD8+T cells ratio in observation group were significantly higher than those in control group(all P<0.05),while the levels of serum VEGF and CEACAM6 were significantly lower than those in control group(all P<0.05).There was no significant difference in 1-year survival rate between the two groups(P>0.05),but the 2-year survival rate in observation group was significantly higher than that in control group(P<0.05).Conclusion Concurrent chemoradiotherapy combined with recombinant human endostatin can down-regulate the expression of serum VEGF and CEACAM6 in patients with advanced cervical cancer,inhibit tumor progression,protect immune function,prolong survival time,and its safety is good.