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同步放化疗联合临床护理路径在食管癌术后患者中的应用价值研究

Study on the Application Value of Concurrent Chemoradiotherapy and Clinical Nursing Pathway for Postoperative Patients with Esophageal Cancer.

作者信息

Yang Jinglei, Zhang Xianzhong, Yang Guangrong, Mi Xiufang, Zhang Yang, Sui Yingzhong

机构信息

Department of Radiophysics, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao 266042, China.

Department of Thoracic Surgery, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao 266042, China.

出版信息

J Oncol. 2022 Sep 15;2022:2216529. doi: 10.1155/2022/2216529. eCollection 2022.

Abstract

BACKGROUNDS

To observe the value of concurrent chemoradiotherapy and clinical nursing pathway for postoperative patients with esophageal cancer (EC).

METHODS

A total of 88 postoperative EC patients were divided into the radiotherapy group (RG group, 44 cases) and the chemoradiotherapy group (CRG group, 44 cases). The RG group received single three-dimensional conformal radiotherapy+clinical nursing pathway, and the CRG group was combined with chemotherapy on this basis. The 5-year overall survival rate, progression-free survival rate, pathological remission and survival rate, lymph node metastasis and survival rate, quality of life analysis, tumor-related factor level, and incidence of adverse reactions were compared between the two groups.

RESULTS

The overall survival rates at 1, 3, and 5 years were 93.18%, 56.82%, and 50.0% in the CRG group and 86.36%, 52.27%, and 43.18% in the RG group, respectively. The 5-year progression-free survival rate of the CRG group was 60.87%, which was clearly higher than that of the RG group (33.33%). The 1-, 3-, and 5-year overall survival rates of pCR and NpCR patients were 90.48%, 80.95%, and 61.90% and 89.55%, 44.78%, and 38.81%, respectively. The overall 1-year, 3-year, and 5-year survival rates were 81.08%, 37.84, and 24.32% and 96.08%, 66.67%, and 62.75% in patients with lymph node metastasis and nonlymph node metastasis, respectively, with statistical significant differences. The emotional function, physical function, cough, pain, and eating difficulty in the CRG group were better than those in the RG group. After treatment, serum CEA, SCC, CYFRA21-1, and CA199 levels in the CRG group were obviously downregulated compared with those in the RG group. There was no obvious difference in the incidence of adverse reactions between the CRG group and the RG group.

CONCLUSION

Single radiotherapy and concurrent chemoradiotherapy can be used as effective means in the treatment of EC. Moreover, the quality of life and survival time of the concurrent chemoradiotherapy group were dramatically better than those of the single radiotherapy group, and the antitumor ability of the concurrent chemoradiotherapy group was stronger.

摘要

背景

观察同步放化疗及临床护理路径应用于食管癌(EC)术后患者的价值。

方法

将88例EC术后患者分为放疗组(RG组,44例)和同步放化疗组(CRG组,44例)。RG组接受单纯三维适形放疗+临床护理路径,CRG组在此基础上联合化疗。比较两组患者的5年总生存率、无进展生存率、病理缓解与生存率、淋巴结转移与生存率、生活质量分析、肿瘤相关因子水平及不良反应发生率。

结果

CRG组1年、3年和5年总生存率分别为93.18%、56.82%和50.0%,RG组分别为86.36%、52.27%和43.18%。CRG组5年无进展生存率为60.87%,明显高于RG组(33.33%)。pCR和NpCR患者的1年、3年和5年总生存率分别为90.48%、80.95%和61.90%以及89.55%、44.78%和38.81%。有淋巴结转移和无淋巴结转移患者的1年、3年和5年总生存率分别为81.08%、37.84%和24.32%以及96.08%、66.67%和62.75%,差异有统计学意义。CRG组的情感功能、身体功能、咳嗽、疼痛及进食困难情况均优于RG组。治疗后,CRG组血清CEA、SCC、CYFRA21-1及CA199水平较RG组明显下调。CRG组与RG组不良反应发生率无明显差异。

结论

单纯放疗和同步放化疗均可作为EC治疗的有效手段。此外,同步放化疗组的生活质量和生存时间明显优于单纯放疗组,且同步放化疗组的抗肿瘤能力更强。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/328c/9499755/ceeb9f344f2c/JO2022-2216529.001.jpg

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