术前短程放疗联合新辅助化疗治疗中低位局部进展期直肠癌效果及安全性分析  

Efficacy and safety of preoperative short-course radiotherapy combined with neoadjuvant chemotherapy in the treatment of locally advanced mid-low rectal cancer

作　　者：郭旭飞 GUO Xufei(Department of Oncology,Liuzhou People's Hospital,Liuzhou 545000,China)

机构地区：[1]柳州市人民医院肿瘤科,广西柳州545000

出　　处：《中国医学物理学杂志》2024年第12期1481-1485,共5页Chinese Journal of Medical Physics

基　　金：广西壮族自治区卫生健康委员会科研课题(Z20200044)。

摘　　要：目的:分析术前短程放疗联合新辅助化疗方案对中低位局部进展期直肠癌的临床效果。方法:选取中低位局部进展期直肠癌患者80例,根据治疗方式的不同将其分为单一组(术前新辅助化疗,32例)和联合组(术前短程放疗联合新辅助化疗,48例),两组放化疗结束后均行全直肠系膜切除术,比较两组临床疗效。比较两组放化疗前后血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、CA199]、免疫功能(CD3^(+)、CD4^(+)、CD8^(+))水平,并记录放化疗期间不良反应发生率。结果:联合组总缓解率较单一组更高(37.50%vs 15.63%,P<0.05)。放化疗后两组血清CEA、CA125和CA199水平均降低,且联合组较单一组更低(P<0.05)。放化疗后单一组和联合组CD3^(+)、CD4^(+)水平均升高,CD8^(+)水平均降低(P<0.05),但两组上述指标比较差异无统计学意义(P>0.05)。两组不良反应比较差异无统计学意义(P>0.05),且两组均未发生Ⅳ级不良反应。结论:术前短程放疗联合新辅助化疗方案应用于中低位局部进展期直肠癌的疗效较好,有利于提高患者总缓解率,降低血清肿瘤标志物水平,且具安全性。Objective To analyze the clinical efficacy of preoperative short-course radiotherapy combined with neoadjuvant chemotherapy in locally advanced mid-low rectal cancer.Methods Eighty patients with locally advanced mid-low advanced rectal cancer were enrolled and assigned to single group(preoperative neoadjuvant chemotherapy,n=32)and combination group(preoperative short-course radiotherapy+neoadjuvant chemotherapy,n=48)according to different treatment methods.All of them underwent total mesorectal resection after chemoradiotherapy.The two groups were compared for clinical curative effect,serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),CA199]and immune function(CD3^(+),CD4^(+),CD8^(+))before and after chemoradiotherapy;and the incidence of adverse reactions during chemoradiotherapy was recorded.Results The overall remission rate was higher in combination group than in single group(37.50%vs 15.63%,P<0.05).After chemoradiotherapy,the levels of serum CEA,CA125 and CA199 in both groups were decreased,and they were lower in combination group than in single group(P<0.05).After chemoradiotherapy,the levels of CD3^(+)and CD4^(+)in single group and combination group increased,and the level of CD8^(+)decreased(P<0.05),but there was no statistically significant differences in the above indicators between two groups(P>0.05).Additionally,the difference in adverse reactions between two group was trivial(P>0.05),and no grade-IV adverse reactions occurred in either group.Conclusion The combination of preoperative short-course radiotherapy and neoadjuvant chemotherapy is effective for locally advanced mid-low advanced rectal cancer,and beneficial for increasing overall remission rate and lowering the levels of serum tumor markers,with high safety.

关 键 词：短程放疗 新辅助化疗 中低位局部进展期直肠癌 

分 类 号：R816.5[医药卫生—放射医学]