多学科模式下新辅助放化疗联合高压氧序贯治疗对直肠癌患者疗效的临床研究  

Clinical study on efficacy of neoadjuvant chemoradiotherapy combined with sequential hyperbaric oxygen therapy under the multidisciplinary model on patients with rectal cancer

作　　者：糜英华[1] 高登鹏 刘振勇 李荣[1] 王相[1] 张霄程[1] 樊巧芝[1] MI Ying-hua;GAO Deng-peng;LIU Zhen-yong(Department of General Surgery,Langfang People's Hospital,Langfang Hebei 065000,China;Department of General Surgery,Langfang Hospital of Traditional Chinese Medicine,Langfang Hebei 065000,China;Department of General Surgery,People's Hospital of Yongqing County,Langfang Hebei 065000,China)

机构地区：[1]廊坊市人民医院普外科,河北廊坊065000 [2]廊坊市中医院普外科,河北廊坊065000 [3]永清县人民医院普外科,河北廊坊065000

出　　处：《临床和实验医学杂志》2022年第4期388-391,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省省级科技计划(编号:162777136);廊坊市科学技术研究与发展计划(编号:2015013046)。

摘　　要：目的探讨多学科模式下新辅助放化疗联合高压氧序贯治疗对直肠癌患者疗效的临床研究。方法前瞻性选取2017年3月至2019年6月于廊坊市人民医院接受住院治疗的直肠癌患者120例,按照随机数字表法分为对照组(n=57)和观察组(n=63)。对照组采用全直肠系膜切除术进行治疗,观察组在此基础上给与新辅助放化疗,同时结合高压氧序贯治疗,治疗3个月。对比两组治疗后的临床疗效,并对比两组治疗前后的肿瘤标志物[癌胚抗原、糖链抗原(CA)125、CA199和CA242]、血管内皮生长因子C(VEGF-C)、鳞状细胞癌抗原(SCC-Ag)水平、生活质量[Karnofsky体力状况(KPS评分)、生活质量(QOL)评分]的差异。结果治疗后,观察组的临床治疗有效率为84.13%,显著高于对照组(68.42%),差异有统计学意义(P<0.05)。治疗后,两组患者血清癌胚抗原、CA125、CA199、CA242水平均显著低于治疗前,观察组患者血清癌胚抗原、CA125、CA199、CA242水平为(26.31±3.05)ng/mL、(59.05±7.04)μg/mL、(478.36±53.21)U/mL、(72.45±8.37)U/mL,均低于对照组[(27.83±3.12)ng/mL、(61.73±5.02)μg/mL、(501.12±54.73)U/mL、(76.12±8.41)U/mL],差异均有统计学意义(P<0.05)。治疗后,两组患者血清VEGF-C、SCC-Ag水平显著低于治疗前,观察组患者血清VEGF-C、SCC-Ag水平为(63.21±7.02)μg/L、(6.57±0.69)mg/L,均显著低于对照组[(66.15±7.13)μg/L、(6.92±0.71)mg/L],差异均有统计学意义(P<0.05)。治疗后,两组患者KPS评分、QOL评分显著高于治疗前,观察组患者KPS评分、QOL评分为(72.35±7.32)、(37.54±4.32)分,显著高于对照组[(68.79±7.21)、(35.32±4.26)分],差异均有统计学意义(P<0.05)。结论多学科模式下新辅助放化疗联合高压氧序贯治疗直肠癌疗效确切,能够显著降低血清癌胚抗原、CA199、CA242水平,改善患者生活质量,值得临床推广采纳。Objective To explore the clinical study on efficacy of neoadjuvant chemoradiotherapy combined with sequential hyperbaric oxygen therapy on patients with rectal cancer under the multidisciplinary model.Methods A total of 120 patients with rectal cancer who were hospitalized in Langfang People's Hospital from March 2017 to June 2019 were prospectively selected and randomly divided into control group(n=57)and observation group(n=63)according to the random number table method.The control group was treated with total mesorectal excision,and the observation group was given neoadjuvant chemoradiotherapy combined with sequential hyperbaric oxygen therapy on this basis,and they were treated for 3 months.The clinical efficacy after treatment was compared between the two groups.The levels of tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen(CA)125,CA199 and CA242],vascular endothelial growth factor C(VEGF-C)and squamous cell carcinoma antigen(SCC-Ag)and scores of quality of life[Karnofsky Performance Status(KPS)score,quality of life(QOL)score]were compared between the two groups before and after treatment.Results After treatment,the clinical treatment effective rate of the observation group was 84.13%,which was significantly higher than that of the control group(68.42%),and the difference was statistically significant(P<0.05).After treatment,the levels of serum CEA,CA125,CA199 and CA242 in the two groups were significantly lower than those before treatment,and the levels of serum CEA,CA125,CA199 and CA242 in the observation group were(26.31±3.05)ng/mL,(59.05±7.04)μg/mL,(478.36±53.21)U/mL,(72.45±8.37)U/mL,which were lower than those in the control group[(27.83±3.12)ng/mL,(61.73±5.02)μg/mL,(501.12±54.73)U/mL,(76.12±8.41)U/mL],the differences were statistically significant(P<0.05).After treatment,the levels of serum VEGF-C and SCC-Ag in the two groups were significantly lower than those before treatment,and the levels of serum VEGF-C and SCC-Ag in study group were(63.21±7.02)μg/L,(6.57±0.69)mg/L,whi

关 键 词：直肠癌 新辅助放化疗 高压氧序贯治疗 

分 类 号：R735.37[医药卫生—肿瘤]