摘要
目的探究不同放疗剂量对局部晚期肺癌患者近远期疗效、血清肿瘤标志物水平与不良反应发生率的影响。方法前瞻性选取2014年1月至2017年11月南通市肿瘤医院收治的接受放疗的局部晚期肺癌患者60例。根据随机数字表法分为高剂量组(n=31)和低剂量组(n=29),高剂量给予等效生物剂量为76~86 Gy,低剂量为60~66Gy。分析2组患者近远期疗效、血清肿瘤标志物[癌胚抗原(CEA)、糖类癌抗原(CA125)、神经元特异性烯醇化酶(NSE)及细胞角蛋白片段(CYFRA21-1)]水平、不良反应发生率。结果高剂量组总有效率74.19%与低剂量组总有效率65.52%比较,差异无统计学意义(P>0.05)。高剂量组生存率87.10%高于低剂量组的82.76%,而复发率和转移率分别为9.68%、9.68%低于低剂量组的13.79%、13.79%,2组比较,差异无统计学意义(P>0.05)。2组患者放疗后CEA、CA125、NSE及CYFRA21-1水平低于放疗前(P<0.001);但高剂量组高于低剂量组[(45.63±7.33)ng/mLvs.(26.46±7.93)ng/mL,(80.66±5.95)U/mL vs.(45.83±5.77)U/mL,(9.22±2.66)ng/mL vs.(5.23±2.25)ng/mL,(24.24±5.57)ng/mL vs.(21.24±5.69)ng/mL],差异有统计学意义(P<0.05)。高剂量组患者不良反应发生率22.58%明显高于低剂量组10.34%,差异有统计学意义(P<0.05)。结论高、低剂量组对局部晚期肺癌患者近远期疗效均无明显差异,但低剂量对患者血清肿瘤标志物水平改善程度优于高剂量,且低剂量不良反应发生率较低,安全性相对较高。
Objective To explore the effects of different doses of radiotherapy on the short-and long-term efficacy,serum tumor marker levels and adverse reactions rate in locally advanced lung cancer patients.Methods Between January 2014 to November 2017,60 patients with locally advanced lung cancer who received radiotherapy were selected form Nantong Tumor Hospital.According to the random number table method,they were divided into high-dose group(31 cases,76~86 Gy)and low-dose group(29 cases,60~66 Gy).The short-and long-term efficacy,serum tumor marker levels[carcinoembryonic Antigen(CEA),carbohydrate carcinoma antigen(CA125),neuron specific enolase(NSE)and cytokeratin fragment(CYFRA21-1)]and adverse reactions rate were analyzed in the two groups.Results In terms of the total effective rate of 74.19%in the high-dose group and 65.52%in the low-dose group,there was no statistically significant difference(P>0.05).The survival rate of the high-dose group was higher than that of the low-dose group(87.10%vs.82.76%),while the recurrence rate and metastasis rate were 9.68% and 9.68%,which were lower than the low-dose group(13.79%vs.13.79%),there was no statistically significant difference between the two groups(P>0.05).The levels of carcinoembryonic antigen(CEA),carbohydrate antigen(CA125),neuron-specific enolase(NSE)and cytokeratin fragment(CYFRA21-1)after radiotherapy were lower than before radiotherapy(P<0.001);high-dose group was higher than low-dose group[(45.63±7.33)ng/mLvs.(26.46±7.93)ng/mL,(80.66±5.95)U/mL vs.(45.83±5.77)U/mL,(9.22±2.66)ng/mL vs.(5.23±2.25)ng/mL,(24.24±5.57)ng/mL vs.(21.24±5.69)ng/mL],and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the high-dose group was 22.58%,which was significantly higher than the low-dose group 10.34%,and the difference was statistically significant(P<0.05).Conclusion There is no statistically significant difference between the high and low dose groups in the short-term and long-term efficacy for locally advanced lung cancer patients,but the low dose improves the serum tumor marker levels better than the high dose with less adverse reaction and high safety.
作者
易琼
倪峰
邰国梅
钱霞
谭程
郭京
YI Qiong;NI Feng;TAI Guo-mei(Department of Radiotherapy,Nantong University Affiliated Tumor Hospital/Nantong Tumor Hospital,Nantong Jiangsu 226361,China)
出处
《临床和实验医学杂志》
2021年第1期32-35,共4页
Journal of Clinical and Experimental Medicine
基金
江苏省南通市科技项目(编号:MS12018096)
江苏省科技计划项目(编号:BE2017679)。
关键词
局部晚期肺癌
放疗剂量
近远期疗效
血清肿瘤标志物
不良反应
Locally advanced lung cancer
Radiotherapy dose
Short-term and long-term efficacy
Serum tumor markers
Adverse reactions
