摘要
目的比较螺旋断层放疗治疗食管癌的临床疗效,探讨其对营养情况、血常规指标、炎症因子、免疫功能的影响并进行安全性分析。方法选取2021年5月至2023年4月江苏省溧阳市人民医院治疗的124例食管癌患者作为研究对象,根据随机数字表法将患者分为螺旋断层放疗组(n=62)和调强放疗组(n=62)。比较两组的临床疗效、营养情况[转铁蛋白(TRF)、前白蛋白(PAB)、血清白蛋白(ALB)]、血常规指标[血红蛋白(HGB)、中性粒细胞计数、白细胞(WBC)计数、血小板计数]、炎症因子[C-反应蛋白(CRP)、白细胞介素(IL)-6、IL-18、肿瘤坏死因子-α(TNF-α)]、免疫功能指标[CD3^(+)T细胞、CD4^(+)T细胞、CD4^(+)T细胞/CD8^(+)T细胞比值、自然杀伤(NK)细胞]以及不良反应发生率。结果螺旋断层放疗组的疾病控制率(88.71%,55/62)显著高于调强放疗组(74.19%,46/62),差异有统计学意义(χ^(2)=4.32,P=0.038)。治疗后螺旋断层放疗组TRF[(178.42±19.24)μg/dl比(171.27±18.19)μg/dl,t=2.13,P=0.035]、PAB[(0.37±0.11)g/L比(0.31±0.09)g/L,t=3.32,P=0.001]、ALB[(4.25±0.52)g/dl比(4.01±0.58)g/dl,t=2.43,P=0.017]高于调强放疗组,差异均有统计学意义。治疗后螺旋断层放疗组HGB[(125.49±13.87)g/dl比(112.37±14.49)g/dl,t=5.21,P<0.001]高于调强放疗组,中性粒细胞计数[(4.91±0.75)×10^(9)/L比(5.37±0.84)×10^(9)/L,t=3.22,P=0.002]、WBC计数[(4.96±0.52)×10^(9)/L比(5.26±0.61)×10^(9)/L,t=2.95,P=0.004]、血小板计数[(227.15±25.38)×10^(9)/L比(241.37±26.91)×10^(9)/L,t=3.03,P=0.003]均低于调强放疗组,差异均有统计学意义。治疗后螺旋断层放疗组CRP[(7.76±0.84)mg/dl比(8.11±1.01)mg/dl,t=2.10,P=0.038]、IL-6[(6.47±0.81)μg/L比(7.16±0.93)μg/L,t=4.41,P<0.001]、IL-18[(191.01±23.14)μg/L比(201.62±22.96)μg/L,t=2.56,P=0.012]、TNF-α[(3.65±0.41)μg/L比(3.82±0.43)μg/L,t=2.25,P=0.026]均低于调强放疗组,差异均有统计学意义。治疗后螺旋断层放疗组CD3^(+)T细胞占比[(41.2
Objective To compare the clinical efficacy of helical tomotherapy in the treatment of esophageal cancer,explore its influence on nutrition status,blood routine indexes,inflammatory factors and immune function,and analyze its safety.Methods A total of 124 patients with esophageal cancer treated in Liyang People's Hospital of Jiangsu Province from May 2021 to April 2023 were selected as the study objects,and the patients were divided into the helical tomotherapy group(n=62)and the modulated arc therapy group(n=62)according to random number table method.The clinical efficacy,nutritional status[transferrin(TRF),prealbumin(PAB),serum albumin(ALB)],blood routine indexes[hemoglobin(HGB),neutrophils count,white blood cells(WBC)count,platelets count],the inflammatory factors[C-reactive protein(CRP),interleukin(IL)-6,IL-18,tumor necrosis factor-α(TNF-α)],immune function indexes[CD3^(+)T cells,CD4^(+)T cells,CD4^(+)T cells/CD8^(+)T cells ratio,natural killer(NK)cells],and the rate of adverse reactions were statistically analyzed.Results The disease control rate of treatment in the helical tomotherapy group(88.71%,55/62)was significantly higher than that in the modulated arc therapy group(74.19%,46/62),with a statistically significant difference(χ^(2)=4.32,P=0.038).After treatment,TRF[(178.42±19.24)μg/dl vs.(171.27±18.19)μg/dl,t=2.13,P=0.035],PAB[(0.37±0.11)g/L vs.(0.31±0.09)g/L,t=3.32,P=0.001],ALB[(4.25±0.52)g/dl vs.(4.01±0.58)g/dl,t=2.43,P=0.017]in the helical tomotherapy group were higher than those in the modulated arc therapy group,with statistically significant differences.After treatment,HGB[(125.49±13.87)g/dl vs.(112.37±14.49)g/dl,t=5.21,P<0.001]in the helical tomotherapy group were higher than those in the modulated arc therapy group;neutrophils count[(4.91±0.75)×10^(9)/L vs.(5.37±0.84)×10^(9)/L,t=3.22,P=0.002],WBC count[(4.96±0.52)×10^(9)/L vs.(5.26±0.61)×10^(9)/L,t=2.95,P=0.004],platelets count[(227.15±25.38)×10^(9)/L vs.(241.37±26.91)×10^(9)/L,t=3.03,P=0.003]in the helical tomotherapy gro
作者
尹浩
吴旭栋
王磊
Yin Hao;Wu Xudong;Wang Lei(Department of Radiation Oncology,Liyang People's Hospital of Jiangsu Province,Liyang 213300,China;Department of Radiation Oncology,Qinhuai Medical District,General Hospital of Eastern Theater Command,Nanjing 210000,China)
出处
《国际肿瘤学杂志》
CAS
2024年第9期578-584,共7页
Journal of International Oncology
关键词
食管肿瘤
放射疗法
计算机辅助
治疗结果
Esophageal neoplasms
Radiotherapy,computer-assisted
Treatment outcome
