同步放化疗与序贯放化疗方案治疗晚期食管癌患者的临床效果比较

Comparison of clinical effects of concurrent chemoradiotherapy and sequential chemoradiotherapy in the treatment of patients with advanced esophageal cancer

目的比较同步放化疗与序贯放化疗方案治疗晚期食管癌患者的临床效果。方法回顾性分析2021年1月至12月收治的120例晚期食管癌患者的临床资料,以放化疗方案差异将其分为同步组(74例)和序贯组(46例)。同步组给予同步放化疗方案治疗,序贯组给予序贯放化疗方案治疗。比较两组的治疗效果。结果同步组的治疗总有效率高于序贯组,差异具有统计学意义(P<0.05)。治疗前,两组的癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原724(CA724)、鳞状细胞癌抗原(SCC)、自然杀伤(NK)细胞及组织多肽抗原(TPA)水平比较,差异无统计学意义(P>0.05);治疗后,同步组的CEA、CA19-9、CA724、SCC及TPA水平低于序贯组,NK细胞高于序贯组,差异具有统计学意义(P<0.05)。同步组的1年生存率高于序贯组,不良反应总发生率低于序贯组,差异具有统计学意义(P<0.05)。结论相较于序贯放化疗方案,同步放化疗治疗晚期食管癌患者具有更高的综合疗效与安全性,值得临床推广及应用。

Objective To compare the clinical effects of concurrent chemoradiotherapy and sequential chemoradiotherapy in the treatment of patients with advanced esophageal cancer.Methods The clinical data of 120 patients with advanced esophageal cancer admitted from January to December 2021 were retrospectively analyzed.According to the difference of chemoradiotherapy regimen,the patients were divided into concurrent group(74 cases)and sequential group(46 cases).The concurrent group was treated with concurrent chemoradiotherapy,and the sequential group was treated with sequential chemoradiotherapy.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the concurrent group was higher than that in the sequential group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in the carcino-embryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 724(CA724),squamous cell carcinoma antigen(SCC),natural killer(NK)cells and tissue polypeptide antigen(TPA)levels between the two groups(P>0.05);after treatment,the levels of CEA,CA19-9,CA724,SCC and TPA in the concurrent group were lower than those in the sequential group,the NK cells was higher than that in the concurrent group,and the differences were statistically significant(P<0.05).The 1-year survival rate of the concurrent group was higher than that of the sequential group,the total incidence of adverse reactions was lower than that of the sequential group,and the differences were statistically significant(P<0.05).Conclusion Compared with sequential chemoradiotherapy,concurrent chemoradiotherapy has higher comprehensive efficacy and safety in the treatment of patients with advanced esophageal cancer,which is worthy of clinical promotion and application.