摘要
目的探讨^(125)I粒子链导管腔内照射在晚期食管癌患者中的应用效果。方法选取自贡市第三人民医院收治的晚期食管癌患者99例,随机数字表法分为对照组49例及观察组50例,对照组采取食道粒子支架植入,观察组采取^(125)I粒子链导管腔内照射治疗。统计两组拔管情况及局部控制率、Neuhaus分级、生化指标[鳞状细胞癌抗原(SCCA)、微小RNA-451(miR-451)、miR-27a、癌胚抗原(CEA)、白蛋白(ALB)、血红蛋白(Hb)、转铁蛋白(TRF)]、不良事件及Karnofsky评分改善率、欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30),随访1年,比较两组生存率。结果两组患者均在无器械断裂或残留的情况下完整取出导管/支架,观察组拔管时间短于对照组(P<0.05);治疗后观察组局部控制率高于对照组,不良事件发生率低于对照组,Karnofsky评分改善率高于对照组(P<0.05);治疗后观察组Neuhaus分级优于对照组(P<0.05);治疗后两组血清SCCA、CEA、miR-451、miR-27a水平低于治疗前,EORTC QLQ-C30评分高于治疗前,且观察组改善优于对照组(P<0.05);治疗后观察组血清ALB、Hb、TRF水平较治疗前升高(P<0.05);治疗后1年,两组生存率比较差异无统计学意义(P>0.05)。结论^(125)I粒子链导管腔内照射治疗有助于提高晚期食管癌患者局部控制率,降低肿瘤标志物水平,改善Neuhaus分级及生活质量,减少不良事件发生率。
Objective To investigate the application effect of ^(125)I particle chain catheter intracavitary irradiation in patients with advanced esophageal cancer.Methods A total of 99 patients with advanced esophageal cancer admitted to our hospital were se-lected.The patients were divided into a control group(n=49)and an observation group(n=50)by using random number table meth-od.The control group was treated with esophageal particle stent implantation.The observation group was treated with ^(125)I particle chain catheter intracavitary irradiation.The extubation and local control rate,Neuhaus classification,biochemical indicators such as squa-mous cell carcinoma antigen(SCCA),microRNA-451(miR-451),miR-27a,carcinoembryonic antigen(CEA),albumin(ALB),hemoglobin(Hb)and transferrin(TRF)and adverse events as well as Karnofsky score improvement rate and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30)were statistically analyzed.The survival rate of the two groups was compared after 1 year of follow-up.Results The catheter/stent was completely removed in both groups without instrument fracture or residue.The extubation time in the observation group was shorter than that in the control group(P<0.05).After treatment,the local control rate of the observation group was higher than that of the control group.The incidence of adverse events in the observation group was lower than that in the control group.The improvement rate of Karnofsky score in the observation group was higher than that in the control group.All differences were statistically significant(P<0.05).After treatment,the Neuhaus classifica-tion of the observation group was better than that of the control group(P<0.05).After treatment,the levels of serum SCCA,CEA,miR-451 and miR-27a in the two groups were lower than those before treatment,the EORTC QLQ-C30 score was higher than that be-fore treatment,and the improvement in the observation group was better than that in the control group(P<0.05).After treatment,the levels of serum ALB,Hb and TRF in the observation group were higher than those before treatment(P<0.05).After 1 year of treat-ment,there was no significant difference in survival rate between the two groups(P>0.05).Conclusions ^(125)I particle chain catheter intracavitary irradiation is helpful to improve the local control rate of advanced esophageal cancer patients,reduce the tumor marker lev-els and improve the Neuhaus classification and quality of life.It also reduces the incidence of adverse events.
作者
郝成罗
陈祥睿
杨晨
詹茜
HAO Cheng-luo;CHEN Xiang-rui;YANG Chen;ZHAN Xi(Department of Hematology and Oncology,Zigong Third People's Hospital,Zigong 643020,China)
出处
《实用医院临床杂志》
2025年第6期159-164,共6页
Practical Journal of Clinical Medicine
基金
四川省医学重点学科项目(编号:23PJ169)
自贡市科技计划自筹经费项目(编号:2023ZC09)。
