摘要
目的探讨三维适形放疗联合沙利度胺治疗食管癌的临床疗效及对患者血清MIP-3α、CA125、VEGF及VEGFR-1的影响。方法选取食管癌患者90例,根据治疗方法的不同分为观察组(n=45)和对照组(n=45)。对照组给予三维适形放疗+同步化疗治疗,观察组在对照组的基础上加用沙利度胺治疗。治疗前及治疗后第3、7周分别采用酶联免疫吸附实验(ELISA)方法测定巨噬细胞炎性蛋白-3α(macrophage inflammatory protein-3 alpha,MIP-3α)、糖类抗原125(糖类抗原125,CA125)与血管内皮生长因子(vascular endothelial growth factor,VEGF)、血管内皮细胞生长因子受体1(vascular endothelial growth factor receptor 1,VEGFR-1)水平。比较2组患者治疗后近期的临床疗效;观察2组患者血液毒性、放射性食管炎、气管炎等治疗毒副作用发生情况;并在治疗后1个月采用生命质量测定量表比较2组患者的生存质量。结果治疗后2组患者血清MIP-3α、CA125、VEGF及VEGFR-1的水平均较治疗前降低(P<0.05);治疗后第3周、第7周观察组患者血清MIP-3α、CA125、VEGF及VEGFR-1的水平均明显低于对照组(P<0.05)。观察组临床总缓解率为68.00%(34/50),明显高于对照组40.00%(20/50)(P<0.05)。观察组患者血液毒性、放射性食管炎、气管炎等治疗毒副作用发生率明显低于对照组(P<0.05)。治疗后1个月观察组躯体功能、社会功能、角色功能、情绪功能以及总体症状均显著优于对照组(P<0.05)。结论三维适形放疗联合沙利度胺治疗食管癌可有效降低损伤正常组织,提高肿瘤的局控率,减少患者治疗过程中的不良反应的发生,近期疗效显著,有助于提高患者的生存质量。
Objective To investigate the efficacy of three-dimensional conformal radiotherapy combined with thalidomide for esophageal cancer,and the effect on serum MIP-3,CA125,VEGF and VEGFR-1. Methods 90 patients with esophageal cancer were selected and divided into the observation group （ n =45） and the control group （ n =45） according to different treatment methods.The control group received three dimensional conformal radiotherapy plus concurrent chemotherapy,and the observation group was treated with thalidomide on the basis of the control group.Using enzyme-linked immunosorbent assay （ELISA） before and 3,7 weeks after treatment to detect macrophage inflammatory protein-3,carbohydrate antigen 125（CA125） and vascular endothelial growth factor （VEGF）,vascular endothelial cell growth factor receptor 1（VEGFR-1） level.The clinical efficacy of the 2 groups after treatment was compared;The blood toxicity,radiation esophagitis,tracheitis and other side effects were observed in the 2 groups;The quality of life of the 2 groups was compared by the QLQ-C30 1 month after treatment. Results The levels of serum MIP-3,CA125,VEGF and VEGFR-1 in the 2 groups were lower than those before treatment （ P 〈0.05）;The levels of serum MIP-3,CA125,VEGF and VEGFR-1 in the observation group were significantly lower than those of the control group 3,7 weeks after treatment （ P 〈0.05）.The total clinical remission rate of the observation group was 68.00% （34/50）,which was significantly higher than that of the control group 40.00% （20/50） （ P 〈0.05）.The incidence of blood toxicity,radiation esophagitis and tracheitis in the observation group was lower than that of the control group （ P 〈0.05）.1 month after treatment,the physical function,social function,role function,emotional function and overall symptoms of the observation group were significantly better than those of the control group （ P 〈0.05）. Conclusion Three dimensional conformal radiotherapy combined with thalidomide in the treatment of patients with esophageal cancer can effectively reduce the damage to normal tissue,improve the tumor local control rate,reduce the adverse reactions during treatment,with significant short-term effect,it can improve the quality of life of patients.
作者
吴尚
WU Shang(Xinyang Central Hospital,Xinyang,46400)
出处
《实用癌症杂志》
2018年第7期1065-1068,共4页
The Practical Journal of Cancer
