调强放疗联合腔内近距离放疗对晚期宫颈癌患者肿瘤标志物及雌孕激素的影响  

Effects of intensity modulated radiotherapy combined with brachytherapy on tumor markers and estrogen and progesterone levels in patients with advanced cervical cancer

作　　者：王巧娥 胡小刚 许海 WANG Qiaoe;HU Xiaogang;XU Hai(Department of Obstetrics and Gynecology,Xiaogan District Maternal and Child Health Care Hospital,Xiaogan 432100,Hubei,China;Department of Orthopedics,Xiaogan First People＇s Hospital,Xiaogan 432100,Hubei,China;Department of Gynecology,Huangjiahu Hospital of Hubei University of Chinese Medicine,Wuhan 430070,Hubei,China)

机构地区：[1]孝感市孝南区妇幼保健院妇产科,湖北孝感432100 [2]孝感市第一人民医院骨科,湖北孝感432100 [3]湖北中医药大学黄家湖医院妇科,武汉430070

出　　处：《中国性科学》2018年第9期32-35,共4页Chinese Journal of Human Sexuality

基　　金：中国博士后科学基金资助项目(2013M542498)

摘　　要：目的:探讨调强放疗联合腔内近距离放疗对晚期宫颈癌患者肿瘤标志物及雌孕激素的影响,分析其可能的作用机制。方法:选择2014年6月至2015年5月孝感市孝南区妇幼保健院收治的88例晚期宫颈癌患者为研究对象,采用随机数字表法将其分为观察组和对照组,每组均为44例。观察组患者在对照组的基础上联合应用局部调强放疗,对照组患者进行腔内近距离放疗,比较两组患者血清肿瘤标志物、雌孕激素、近期疗效、毒副反应等指标。结果:观察组患者治疗有效率93. 18%,明显高于对照组患者治疗有效率72. 73%(χ~2=6. 510,P <0. 05);观察组患者血清甲状腺球蛋白(SCC-Ag)、癌胚抗原(CEA)、糖类抗原50(CA50)、糖类抗原72-4(CA724)含量均明显低于对照组患者(t=7. 388～32. 883,P <0. 05,P <0. 01);观察组患者血清雌二醇(E2)、孕酮(P)含量明显高于对照组患者,促卵泡激素(FSH)、黄体生成素(LH)含量明显低于对照组患者(t=5. 285～22. 531,P <0. 05,P <0. 01);观察组患者放射性直肠炎、放射性膀胱炎均明显低于对照组患者(22. 63%vs 43. 18%,4. 55%vs 17. 18%)(χ~2=4. 166,4. 061,P <0. 05)。结论:调强放疗联合腔内近距离放疗有助于提高晚期宫颈癌患者近期疗效,减少放射性损伤,可能与降低血清肿瘤标志物含量、调节雌孕激素水平等因素有关。Objective：To investigate the effect of intensity modulated radiation therapy （IMRT） combined with brachytherapy in the treatment of cervical cancer patients with advanced cervical cancer. Methods ： 88 patients with advanced cervical cancer admitted in Xiaogan District Maternal and Child Health Care Hospital from June 2014 to May 2015 were selected and randomly divided into observation group and control group with 44 cases in each group. The control group was given brachytherapy, and on such basis the observation group was given local radiotherapy. The serum tumor markers, estrogen and progesterone levels, short-term curative effects and toxic and side effect were compared between the two groups. Results： The effective rate of observation group was 93.18% significantly higher than the control group of 72.73% （χ2 = 6.510, P 〈 0.05）. The serum thyroglobulin （SCC-Ag）, carcinoembryonic antigen （ CEA）, carbohydrate antigen 50 （ CA50）, carbohydrate antigen 72-4 （CA724） content in the observation group were significantly lower than those in the control group （t = 7. 388 -32. 883, P 〈 0.05, P 〈 0.01 ）. The serum estradiol （E2） and progesterone （P） were significantly higher than those in the control group, and follicle stimulating hormone （FSH） and luteinizing hormone （LH） were significantly lower than those of the control group （t = 5. 285 - 22. 531, P 〈 0.05, P 〈 0.01 ）. The radiation proctitis and cystitis were significantly lower than those in the control group （22.63% vs 43. 18% , 4.55% vs 17.18%） （χ2 =4. 166, 4. 061, P 〈 0. 05 ）. Conclusions： Intensity-modulated radiotherapy combined with intracavitary brachytherapy is conducive to improving the short-term efficacy of advanced cervical cancer patients and reducing radiation damage, which may be related to the decrease of serum tumor marker content, regulation of estrogen and progesterone levels and other factors.

关 键 词：晚期宫颈癌 腔内近距离放疗 调强放疗 肿瘤标志物 雌孕激素 

分 类 号：R737.33[医药卫生—肿瘤]