不同剂量放疗联合化疗对中晚期食管癌患者循环肿瘤细胞及3年生存率的影响

Effects of Different Radiotherapy Doses Combined with Chemotherapy on Circulating Tumor Cells and 3-year Survival Rate in Patients with Advanced Esophageal Cancer

目的 探讨不同剂量放疗联合化疗对中晚期食管癌患者循环肿瘤细胞(CTCs)及3年生存率的影响。方法 选取2017年1月—2018年1月收治的中晚期食管癌135例,按放疗剂量分为观察组67例和对照组68例。2组均给予相同的化疗方案,观察组在化疗基础上采取高剂量三维适形放疗,对照组在化疗基础上采取低剂量三维适形放疗。比较2组临床疗效,治疗前、后CTCs阳性比例,毒副作用发生情况;比较2组治疗前、后世界卫生组织生存质量量表(WHOQOL-100)评分和3年生存率。结果 治疗后观察组客观缓解率高于对照组,CTCs阳性比例低于对照组(P<0.05)。2组毒副作用发生率比较差异无统计学意义(P>0.05)。治疗后2组WHOQOL-100生理状态、心理状态、情绪状态、独立能力评分均优于治疗前,且观察组优于对照组(P<0.05)。Kaplan-Meier生存分析显示,观察组3年生存率高于对照组(P<0.05)。结论 在相同化疗的基础上联合使用高剂量放疗对中晚期食管癌患者进行治疗临床效果更好,且对肿瘤细胞的控制和患者3年生存率有明显的积极作用。

Objective To investigate the effects of different doses of radiotherapy combined with chemotherapy on circulating tumor cells(CTCs) and 3-year survival rate of patients with advanced esophageal cancer(AEC). Methods In total, 135 cases of AEC admitted from January 2017 to January 2018 were selected and divided into observation group(n=67) and control group(n=68) according to radiotherapy dose. Both groups were given the same chemotherapy regimen, the observation group was given high-dose three-dimensional conformal radiotherapy on the basis of chemotherapy, and the control group was given low-dose three-dimensional conformal radiotherapy on the basis of chemotherapy. The clinical efficacy, positive proportion of CTCs before and after treatment, and incidence of toxic and side effects of the two groups were compared. The World Health Organization quality of life scale(WHOQOL-100) score and 3-year survival rate were compared between the two groups before and after treatment. Results After treatment, the objective remission rate of the observation group was higher than that of the control group, and the positive proportion of CTCs was lower than that of the control group(P<0.05). There was no significant difference in the incidence of toxic and side effects between the two groups(P>0.05). After treatment, WHOQOL-100 score of the physiological state, psychological state, emotional state and independent ability in the two groups were better than those before treatment, which were better in the observation group than in the control group(P<0.05). Kaplan-Meier survival analysis showed that the 3-year survival rate of observation group was higher than that of control group(P<0.05). Conclusion The same chemotherapy combined with high-dose radiotherapy for the treatment of patients with AEC has better clinical efficacy, and has a significantly positive effect on tumor cell control and 3-year survival rate.