调强放疗联合腔内近距离放疗对中晚期宫颈鳞癌患者肿瘤标志物的影响

Effect of Intensity Modulated Radiotherapy Combined with Intracavitary Brachytherapy on Tumor Markers in Patients with Advanced Cervical Squamous Cell Carcinoma

目的研究调强放疗(IMRT)联合腔内近距离放疗对中晚期宫颈鳞癌患者肿瘤标志物的影响。方法选取2016年1月-2021年10月我院收治的100例中晚期宫颈鳞癌患者作为研究对象,依据随机数字表法分为对照组和治疗组,每组50例。对照组给予三维适形外放疗联合腔内近距离放疗,治疗组在对照组基础上应用IMRT治疗,比较两组近期疗效、肿瘤标志物水平[鳞状细胞癌抗原(SCC)、癌胚抗原(CEA)、细胞角蛋白19片段抗原21-1(Cyfra-21-1)]、性激素水平[血清雌二醇(E_(2))、孕酮(P)、促卵泡激素(FSH)]、不良反应、预后情况(复发转移率、病死率、生活质量)。结果治疗组客观缓解率为82.00%,高于对照组的70.00%(P<0.05);两组治疗后SCC、CEA、Cyfra-21-1水平低于治疗前,且治疗组低于对照组(P<0.05);两组治疗后E_(2)、P水平低于治疗前,FSH水平高于治疗前,但治疗组E_(2)、P水平高于对照组,FSH水平低于对照组(P<0.05);治疗组不良反应发生率低于对照组(P<0.05);治疗后3个月,两组均无复发转移及病死情况,治疗组SF-36评分高于对照组(P<0.05)。结论IMRT联合腔内近距离放疗在中晚期宫颈鳞癌患者中具有确切疗效,可下调血清肿瘤标志物水平,缓解卵巢损伤,降低不良反应发生几率,有利于患者预后及生活质量的改善。

Objective To study the effect of intensity-modulated radiotherapy(IMRT)combined with intracavitary brachytherapy on tumor markers in patients with advanced cervical squamous cell carcinoma.Methods A total of 100 patients with advanced cervical squamous cell carcinoma admitted to our hospital from January 2016 to October 2021 were randomly divided into a control group and a treatment group,with 50 patients in each group.The control group was treated with three-dimensional conformal external radiotherapy combined with intracavitary brachytherapy,and the treatment group was treated with IMRT on the basis of the control group.The short-term efficacy,tumor marker levels[squamous cell carcinoma antigen(SCC),carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(Cyfra-21-1)],sex hormone levels[serum estradiol(E_(2)),progesterone(P),follicle stimulating hormone(FSH)],adverse reactions and prognosis(recurrence and metastasis rate,mortality,quality of life)were compared between the two groups.Results The objective remission rate of the treatment group was 82.00%,which was higher than 70.00%of the control group(P<0.05).After treatment,the levels of SCC,CEA and Cyfra-21-1 in the two groups were lower than those before treatment,and those in the treatment group were lower than the control group(P<0.05).After treatment,the levels of E_(2) and P in the two groups were lower than those before treatment,and the level of FSH was higher than that before treatment,but the levels of E_(2) and P in the treatment group were higher than those in the control group,and the level of FSH was lower than that in the control group(P<0.05).The incidence of adverse reactions in treatment group was lower than that in control group(P<0.05).Three months after treatment,there was no recurrence,metastasis and death in the two groups,the SF-36 score in the treatment group was higher than that in the control group(P<0.05).Conclusion IMRT combined with intracavitary brachytherapy is effective in patients with advanced cervical squamous cell carcinoma,which can down-regulate the level of serum tumor markers,alleviate ovarian injury,reduce the incidence of adverse reactions,and improve the quality of life of patients.