三维适形调强放疗同步化疗在直肠癌术前的应用及对肿瘤标记物、预后生存的影响  

Application of three-dimensional conformal intensity-modulated radiotherapy combined with chemotherapy before rectal cancer surgery and their effect on tumor markers and the prognosis

作　　者：贾亚辉 宋小珍 曾祥学 张跃强 Jia Yahui;Song Xiaozhen;Zeng Xiangxue;Zhang Yueqiang(Department of Oncology,Traditional Chinese Medicine Hospital of Zhoukou,Zhoukou 466000,China)

机构地区：[1]河南省周口市中医院肿瘤科,466000

出　　处：《临床医学》2023年第5期18-21,共4页Clinical Medicine

摘　　要：目的 探讨术前三维适形调强放疗同步化疗对直肠癌患者肿瘤标记物、预后生存的影响。方法 回顾性分析2019年6月至2021年10月周口市中医院收治的85例直肠癌患者的临床资料,按照直肠癌术前治疗方式分为对照组(n=40)与研究组(n=45),对照组给予单纯辅助化疗,研究组给予三维适形调强放疗同步化疗。治疗前后比较两组近期疗效、肿瘤标记物[癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、基质金属蛋白酶-9(MMP-9)]、不良反应及预后生存情况。结果 研究组治疗有效率为93.33%(42/45),对照组为70.00%(28/40),两组比较差异有统计学意义(P<0.05)。辅助治疗后4周,研究组CEA、CA19-9、MMP-9水平低于对照组,差异有统计学意义(P<0.05)。随访截至2023年1月,两组辅助治疗相关不良反应发生率比较,差异未见统计学意义(P>0.05),研究组局部复发率、远期转移率低于对照组,累积生存率高于对照组,差异均有统计学意义(P均<0.05)。结论 术前三维适形调强放疗同步化疗可以增加直肠癌术后患者近期疗效,有效降低CEA、CA19-9、MMP-9水平,提高远期生存率。Objective To investigate the application of preoperative three-dimensional conformal intensity-modulated radiotherapy combined with chemotherapy before rectal cancer surgery and their effect on tumor markers and the prognosis.Methods From June 2019 to October 2021,the clinical data of 85 patients with rectal cancer admitted to Zhoukou Hospital of Traditional Chinese Medicine were retrospectively analyzed.According to the preoperative treatment of rectal cancer,the patients were divided into control group(n=40) and study group(n=45),the control group was treated with adjuvant chemotherapy alone,while the study group was treated with three-dimensional intensity modulated radiation therapy combined with concurrent chemotherapy.The short-term curative effects,tumor markers [carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),matrix metalloproteinase-9(Mmp-9)],adverse reactions and prognosis were compared between the two groups before and after treatment.Results The effective rate was 93.33%(42/45) in study group and 70.00%(28/40) in control group,there was significant differences between the two groups(P<0.05).Four weeks after adjuvant therapy,the levels of CEA,CA19-9 and MMP-9 in the study group were significantly lower than those in the control group(P<0.05).The follow-up was up to January 2023,and there was no significant difference in adjuvant treatment-related adverse reactions between the two groups(P>0.05).The local recurrence rate and long-term metastasis rate in the study group were lower than those in the control group,and the cumulative survival rate was significantly higher than that of the control group,there were significant differences(P<0.05).Conclusions Preoperative three-dimensional conformal intensity-modulated radiotherapy combined with chemotherapy can improve the short-term efficacy in rectal cancer patients after surgery,effectively lower the levels of CEA,CA19-9 and MMP-9,and improve long-term survival rate.

关 键 词：直肠癌 术前 三维适形调强放疗 化疗 肿瘤标记物 预后生存 

分 类 号：R735.37[医药卫生—肿瘤]