摘要目的:分析同步放化疗治疗中晚期食管癌的疗效及对其血清转化生长因子-β1(TGF-β1)、胰岛素样生长因子-1(IGF-1)和预后的影响。方法:选取我院2016年6月至2018年1月收治的中晚期食管癌患者98例,根据随机数字表法分为对照组(55例)和研究组(43例),对照组采用序贯放化疗,研究组采用同步放化疗,比较两组临床疗效,血清TGF-β1、IGF-1水平,安全性发生情况,生存情况。结果:研究组客观缓解率高于对照组,有统计学差异(79.09% vs51.18% P<0.05)。治疗后,两组血清TGF-β1、IGF-1水平均下降,研究组低于对照组[(139.09±14.29)vs(285.71±36.10)mg/L、(55.43±6.75)vs(80.21±10.43)μg/L,P<0.05)]。研究组恶心、呕吐,白细胞下降率高于对照组(67.72%5 vs 86.04%、20.00% vs 39.53%,P<0.05),两组放射性食管炎、转氨酶上升率比较无统计学差异(9.09% vs 13.95%、5.45% vs 9.30%,P>0.05)。随访期间,研究组中位生存时间长于对照组[26.8(95%CI:23.585~30.089)月 vs 23.0(95%CI:20.142~25.895)月,P<0.05]。结论:同步放化疗治疗中晚期食管癌具有良好的疗效,可降低血清TGF-β1、IGF-1水平,延长患者生存时间,毒副作用可耐受。
Abstract：Objective: To analyze the efficacy of concurrent chemoradiotherapy in the treatment of advanced esophageal cancer and its influences on serum transforming growth factor-1 (TGF-β1), insulin-like growth factor-1 (IGF-1) and prognosis. Methods: 98 patients from June 2016 to January 2018 with advanced esophageal cancer were divided into 55 control group and 43 research group according to the random number table method. The control group was treated with sequential chemoradiotherapy, and the research group was treated with concurrent chemoradiotherapy. Results: The Objective remission rate of the study group was higher than that of the control group (79.09% vs 51.18% P < 0.05). After treatment, the levels of serum TGF-beta 1 and IGF-1 in both groups decreased, and the levels of serum TGF-beta 1 and IGF-1 in the study group were lower than those in the control group [(139.09+14.29) vs (285.71+36.10) mg/L, (55.43+6.75) vs (80.21+10.43) ug/L, P < 0.05]. The rate of nausea, vomiting and leukocyte decrease in the study group was higher than that in the control group (67.72% vs 86.04%, 20.00% vs 39.53%, P < 0.05). There was no significant difference in the rate of radioesophagitis and transaminase increase between the two groups (9.09% vs 13.95%, 5.45% vs 9.30%, P > 0.05). During the follow-up period, the median survival time of the study group was longer than that of the control group [26.8 (95% CI: 23.585-30.089) months vs 23.0 (95% CI: 20.142-25.895) months, P < 0.05]. Conclusion: Concurrent chemoradiotherapy has a good effect in the treatment of advanced esophageal cancer. It can reduce the levels of serum TGF-beta 1 and IGF-1, prolong the survival time of patients, and tolerate the toxicity and side effects.
[1] Hamai Y, Emi M, Ibuki Y, Murakami Y, et al. Early recurrence and cancer death after trimodal therapy for esophageal squamous cell carcinoma[J]. Anticancer Res,2019,39(3):1433~1440. [2] 杨燕, 李建成,王胜强,等.同步放化疗与序贯化放疗治疗中晚期食管癌的临床观察[J].临床肿瘤学杂志,2018,23(3):251~254. [3] 柯军,路逹,成国建.同步放化疗与序贯放化疗对晚期食管癌的临床疗效分析[J].中国肿瘤临床与康复,2017,24(12):1495~1498. [4] 张娟,曹婷婷.食管癌患者血清血管内皮生长因子、胰岛素样生长因子-1表达及其与临床病理特征的关系[J].中国实验诊断学,2018,22(7):1152~1155. [5] Ising MS, Marino K, Trivedi JR, et al. Influence of neoadjuvant radiation dose on patients undergoing esophagectomy and survival in locally advanced esophageal cancer[J].Gastrointest Surg,2019,23(4):670~678. [6] Katano A, Yamashita H, Nakagawa K. Successful definitive concurrent chemoradiotherapy in a patient with esophageal cancer and Child-Pugh B cirrhosis of the liver[J].Cancer Res Ther,2019,15(1):255~257. [7] 潘险峰,龙健.同步放化疗联合治疗晚期食管癌临床探讨[J].河北医学,2015,21(4):615~617. [8] 武静,任筱璐,李波,等.食管癌同步放化疗与序贯放化疗的疗效分析[J].中国药物与临床,2015,15(11):1634~1636. [9] 马兆明,刘桂荣,邵艳,等.中晚期食管癌同步放化疗与序贯性放化疗疗效对比[J].现代肿瘤医学,2016,24(3):397~400. [10] D’Haene N, Le Mercier M, Salmon I, et al. SMAD4 mutation in small cell transformation of epidermal growth factor receptor mutated lung adenocarcinoma[J]. Oncologist,2019,24(1):9~13. [11] 杨健筌, 郭文,李光明.同步放化疗与序贯放化疗对食管癌预后影响的Meta分析[J].实用癌症杂志,2016,31(4):588~594.
2019, Vol. 25 
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