调强放疗联合化疗治疗食管癌患者的临床疗效与安全性

Clinical efficacy and safety of intensity-modulated radiotherapy combined with chemotherapy in the treatment of patients with esophageal cancer

目的 探讨调强放疗联合化疗治疗食管癌患者的临床疗效与安全性。方法 根据治疗方法的不同将102例食管癌患者分为常规组(n=51,接受常规放疗联合化疗)和调强组(n=51,接受调强放疗联合化疗)。比较两组患者的临床疗效、血清肿瘤标志物[胰岛素样生长因子1(IGF1)、血管内皮生长因子(VEGF)、鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)]水平、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+))及不良反应发生率。结果 调强组患者的临床疗效明显优于常规组(P﹤0.01)。治疗后,两组患者的IGF1、VEGF、SCC-Ag、CEA水平均低于本组治疗前,且调强组患者的IGF1、VEGF、SCC-Ag、CEA水平均低于常规组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者的CD3^(+)、CD4^(+)、CD8^(+)水平均低于本组治疗前,常规组患者的CD4^(+)/CD8^(+)低于本组治疗前,调强组患者的CD4^(+)/CD8^(+)高于本组治疗前,且调强组患者的CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于常规组,CD8^(+)水平低于常规组,差异均有统计学意义(P﹤0.05)。调强组患者放射性食管炎、放射性肺炎、骨髓抑制的发生率均低于常规组,差异均有统计学意义(P﹤0.05)。结论 调强放疗联合化疗可提高食管癌患者的临床疗效,降低血清肿瘤标志物水平,提高患者的免疫功能和治疗安全性。

Objective To investigate the clinical efficacy and safety of intensity-modulated radiotherapy combined with chemotherapy in the treatment of patients with esophageal cancer. Method A total of 102 patients with esophageal cancer were divided into conventional group(n=51, receiving conventional radiotherapy combined with chemotherapy)and intensity-modulated group(n=51, receiving intensity-modulated radiotherapy combined with chemotherapy) according to different treatment methods. The clinical efficacy, serum tumor markers [insulin like growth factor 1(IGF1), vascular endothelial growth factor(VEGF), squamous cell carcinoma antigen(SCC-Ag), carcinoembryonic antigen(CEA)] levels, T lymphocyte subsets(CD3^(+), CD4^(+), CD8^(+)levels, and CD4^(+)/CD8^(+)), the incidence of adverse reactions were compared between the two groups. Result The clinical efficacy of the patients in the intensity-modulated group was significantly better than that in the conventional group(P<0.01). After treatment, the levels of IGF1, VEGF, SCC-Ag and CEA in the two groups were lower than those before treatment, and the levels of IGF1, VEGF, SCC-Ag and CEA in the intensitymodulated group were lower than those in the conventional group, and the differences were statistically significant(P<0.05). After treatment, the levels of CD3^(+), CD4^(+)and CD8^(+)in the two groups were lower than those before treatment, and the CD4^(+)/CD8^(+)in the conventional group was lower than that before treatment, while the CD4^(+)/CD8^(+)in the intensity-modulated group was higher than that before treatment, the CD3^(+), CD4^(+)levels and CD4^(+)/CD8^(+)in the intensity-modulated group were higher than those in the conventional group, and the CD8^(+)level in the intensity-modulated group was lower than that in the conventional group, the differences were statistically significant(P<0.05). The incidence of radiation esophagitis, radiation pneumonitis, and myelosuppression in the intensity-modulated group were lower than those in the conventional group, and the differences were statistically significant(P<0.05). Conclusion Intensity-modulated radiotherapy combined with chemotherapy can improve the clinical efficacy of esophageal cancer patients, reduce the level of serum tumor markers, and improve patients’ immune function and treatment safety.