CT模拟定位三维适形放疗联合TP方案对晚期食管癌患者血清SCC水平及预后的影响  

Effect of CT simulation positioning and three-dimensional conformal radiotherapy combined with TP regimen on serum SCC level and prognosis of advanced esophageal cancer

作　　者：古丽娜尔·吐尔地[1] 朱成斌[1] 赵辉[1] 孙毅[2] Gulinaer tuerdi;Zhu Chengbin;Zhao Hui;Sun Yi(Radiotherapy Center,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Cancer Tumor,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院放疗中心,乌鲁木齐830001 [2]新疆医科大学第一附属医院肿瘤中心,乌鲁木齐830001

出　　处：《中国医师杂志》2021年第12期1838-1841,1846,共5页Journal of Chinese Physician

基　　金：新疆维吾尔自治区自然科学基金(2019D01C108)。

摘　　要：目的探究CT模拟定位三维适形放疗联合紫杉醇与顺铂(TP)方案对晚期食管癌患者血清鳞状上皮细胞癌抗原(SCC)水平及预后的影响。方法选取新疆维吾尔自治区人民医院2016年6月至2017年10月收治的80例晚期食管癌患者,按照随机数字表法分为观察组和对照组,各40例。其中对照组给予CT模拟定位三维适形放疗联合顺铂及多西他赛治疗,观察组给予CT模拟定位三维适形放疗联合TP方案治疗。比较2组临床疗效,肿瘤标志物水平[血清SCC、癌胚抗原(CEA)、糖类抗原-199(CA-199)、人细胞角蛋白21-1片段(CYFRA21-1)水平],卡氏功能状态(KPS)评分、肿瘤患者生活质量(QOL)评分,无进展生存期及不良反应发生率。结果治疗后,观察组总有效率为70.00%,明显高于对照组的55.00%(P<0.05);2组患者治疗后的血清SCC、CEA、CA-199、CYFRA21-1水平较治疗前均明显降低(P<0.05),且观察组明显低于对照组(P<0.05);2组患者治疗后的QOL、KPS评分较治疗前均明显升高(P<0.05),且观察组明显高于对照组(P<0.05);观察组无进展生存期明显长于对照组(P<0.05);观察组不良反应发生率为15.00%,与对照组的25.00%比较差异无统计学意义(P>0.05)。结论CT模拟定位三维适形放疗联合TP方案治疗晚期食管癌效果明显,可有效降低肿瘤标志物水平,改善患者身体功能及生活质量,改善预后,且不会增加不良反应发生率,安全有效。Objective To investigate the effects of CT simulation positioning and three-dimensional conformal radiotherapy combined with regimen of paclitaxel and cisplatin(TP)on serum squamous cell carcinoma antigen(SCC)level and prognosis in patients with advanced esophageal cancer.Methods A total of 80 cases of advanced esophageal cancer patients in People′s Hospital of Xinjiang Uygur Autonomous Region from June 2016 to October 2017 were selected and randomly divided into treatment group and control group,with 40 cases in each group.The control group was treated with CT simulation positioning three-dimensional combined cisplatin and Docetaxel,and the treatment group was treated with CT simulation positioning three-dimensional combined TP regimen.The clinical efficacy,tumor marker levels[serum SCC,carcinoembryonic antigen(CEA),carbohydrate antigen-199(CA-199),human cytokeratin 21-1 fragment(CYFRA21-1)],Karnofsky functional status(KPS)score,Quality of Life(QOL)score,progression free survival period and incidence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate in the treatment group was 70.00%,which was significantly higher than 55.00%in the control group(P<0.05);the levels of serum SCC,CEA,CA-199 and CYFRA21-1 in the two groups after treatment were significantly lower than those before treatment(P<0.05),and those in the treatment group were significantly lower than those in the control group(P<0.05);after treatment,the QOL and KPS scores in the two groups were significantly higher than those before treatment(P<0.05),and the scores in the treatment group were significantly higher than those in the control group(P<0.05);The progression free survival time in the treatment group was significantly longer than that in the control group(P<0.05);The incidence of adverse reactions in the treatment group was 15.00%,which had no significant difference compared with 25.00%in the control group(P>0.05).Conclusions CT simulation positioning three-dimensional combined with TP reg

关 键 词：食管肿瘤 适形放射疗法 三维 体层摄影术 紫杉醇 顺铂 SCC抗原 

分 类 号：R735.1[医药卫生—肿瘤]