诱导化疗联合调强放疗对食管鳞状细胞癌患者生存期及免疫功能的影响  

Effect of induction chemotherapy combined with intensity-modulated radiotherapy on survival and immune function of patients with esophageal squamous cell carcinoma

作　　者：李冬[1] 岳成山 高山[1] 王会霞[1] 丁海燕[1] 董学良[1] LI Dong;YUE Chengshan;GAO Shan;WANG Huixia;DING Haiyan;DONG Xueliang(Department of Radiotherapy,Hanzhong Central Hospital,Hanzhong 723000,Shaanxi,China)

机构地区：[1]汉中市中心医院放疗科,陕西汉中7230000

出　　处：《癌症进展》2020年第24期2535-2538,2546,共5页Oncology Progress

摘　　要：目的探讨诱导化疗联合调强放疗对食管鳞状细胞癌患者生存期及免疫功能的影响。方法根据治疗方案将112例食管鳞状细胞癌患者分为观察组(n=52,接受诱导化疗^+调强放疗治疗)和对照组(n=60,接受诱导化疗^+同步放化疗治疗)。比较两组患者的近期疗效[客观缓解率(ORR)、疾病控制率(DCR)]、生存情况[生存率、中位总生存时间(OS)及中位无进展生存时间(PFS)]、淋巴细胞亚群(CD4^+、CD8^+和CD4^+/CD8^+)变化及不良反应发生情况。结果治疗后3个月,两组患者CD4^+水平和CD4^+/CD8^+均低于本组治疗前,CD8^+水平高于本组治疗前,且观察组患者CD4^+水平和CD4^+/CD8^+均高于对照组,CD8^+水平低于对照组,差异均有统计学意义(P﹤0.05)。临床分期为Ⅱ期的观察组和对照组食管鳞状细胞癌患者的生存率均高于临床分期为Ⅲ~Ⅳ期的患者,差异均有统计学意义(P﹤0.05)。两组患者ORR、DCR比较,差异均无统计学意义(P﹥0.05)。观察组患者的中位OS和PFS分别为27.48个月、13.56个月,与对照组患者的23.66个月、10.90个月比较,差异均无统计学意义(P﹥0.05)。观察组患者Ⅲ级及以上骨髓抑制、恶心呕吐发生率均低于对照组患者,差异均有统计学意义(P﹤0.05)。结论诱导化疗联合调强放疗与同步放化疗治疗食管鳞状细胞癌的疗效无明显差异,但诱导化疗联合调强放疗可减少化疗药物对机体免疫功能的影响,减少不良反应的发生风险。Objective To explore the effect of induction chemotherapy combined with intensity-modulated radiotherapy on the survival and immune function of patients with esophageal squamous cell carcinoma.Method According to the treatment plan,112 patients with esophageal squamous cell carcinoma were divided into observation group(n=52,receiving induction chemotherapy^+intensity-modulated radiotherapy)and control group(n=60,receiving induction chemotherapy^+concurrent radiochemotherapy).The short-term efficacy[objective response rate(ORR),disease control rate(DCR)],survival status[survival rate,median overall survival(OS)and median progression-free survival(PFS)],lymphocyte subsets(CD4^+,CD8^+and CD4^+/CD8^+)and the occurrence of adverse reactions between the two groups.Result Three months after treatment,the CD4^+level and CD4^+/CD8^+of the two groups were lower than those before treatment,and the CD8^+level were higher than those before the treatment,and the CD4^+level and CD4^+/CD8^+in the observation group were higher than the control group,and the CD8^+level was lower than the control group,the difference was statistically significant(P<0.05).The survival rate of patients with esophageal squamous cell carcinoma in the observation group and control group with clinical stage Ⅱ was higher than that of patients with clinical stage Ⅲ-Ⅳ,and the difference was statistically significant(P<0.05).There was no statistically significant difference in ORR and DCR between the two groups of patients(P>0.05).The median OS and PFS in the observation group were 27.48 months and 13.56 months,respectively,compared with the 23.66 months and 10.90 months of the control group,the difference was not statistically significant(P>0.05).The incidence of bone marrow suppression and nausea and vomiting of patients with grade Ⅲ and above in the observation group were lower than those in the control group,and the differences was statistically significant(P<0.05).Conclusion The efficacy of induction chemotherapy combined with intensity modulate

关 键 词：诱导化疗 调强放疗 食管鳞状细胞癌 生存分析 淋巴免疫反应 

分 类 号：R735.1[医药卫生—肿瘤]