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目的探讨替吉奥胶囊联合三维适型放射治疗老年贲门癌的疗效及安全性。方法选取2010年5月至2014年10月间收治的79例老年贲门癌患者(≥55岁)为研究对象,根据患者意愿分为观察组(44例)和对照组(35例)。观察组患者采用常规治疗+三维适型放疗+替吉奥胶囊口服,对照组患者采用常规治疗+三维适型放疗。比较两组患者治疗前后胃蛋白酶原(PG)、癌胚抗原(CEA)及糖类抗原19-9(CA19-9)水平。治疗3个周期后,比较两组患者的客观缓解率。分析两组患者随访后的生存情况及不良反应发生率。结果两组患者治疗前PGⅠ、PGⅡ、CEA、CA19-9的差异均无统计学意义(P>0.05);治疗3个周期后,观察组患者PGⅠ及PGⅡ水平显著高于对照组(P<0.05),CEA及CA19-9水平显著低于对照组(P<0.05)。治疗3个周期后,观察组患者的客观缓解率明显高于对照组(72.7%和45.7%;2=15.200,P<0.05)。观察组患者的无进展生存期为(13.72±1.79)个月,总生存期为(20.30±4.16)个月,对照组分别为(8.53±0.67)个月和(19.23±1.68)个月。观察组患者的无进展生存期显著高于对照组,差异有统计学意义(P<0.05),两组患者总生存期的差异无统计学意义(P>0.05)。两组患者均有血液系统、消化系统、神经系统毒性反应及放射性损害,但均在可耐受范围内。两组患者不良反应发生率的差异无统计学意义(P<0.05)。结论替吉奥胶囊联合三维适型放疗在减少老年贲门癌患者CEA和CA19-9水平方面有一定作用,能够有效延长患者无进展生存期,疗效确切,值得临床推广应用。
Objective To investigate the efficacy and safety of TEGO capsules combined with three-dimensional conformal radiation in the treatment of cardia cancer in the elderly. Methods A total of 79 elderly patients with cardia cancer (≥55 years old) who were admitted between May 2010 and October 2014 were selected as the study group and divided into observation group (44 cases) and control group (35 cases) according to their wishes. The patients in the observation group were treated with conventional therapy, three-dimensional conformal radiotherapy and TIGO capsules, while those in the control group were treated with conventional therapy and three-dimensional conformal radiotherapy. The levels of pepsinogen (PG), carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were compared between the two groups before and after treatment. After 3 cycles of treatment, objective response rates were compared between the two groups. The survival and adverse reactions of the two groups were analyzed after follow-up. Results There was no significant difference in the levels of PGⅠ, PGⅡ, CEA and CA19-9 between the two groups before treatment (P> 0.05). After three cycles, the levels of PGⅠ and PGⅡ in the observation group were significantly higher than those in the control group ), CEA and CA19-9 levels were significantly lower than the control group (P <0.05). After 3 cycles of treatment, the objective response rate of the observation group was significantly higher than that of the control group (72.7% and 45.7%; 2 = 15.200, P <0.05). The progression-free survival was (13.72 ± 1.79) months in the observation group and (20.30 ± 4.16) months in the observation group and (8.53 ± 0.67) months and (19.23 ± 1.68) months in the control group respectively. The progression-free survival rate in the observation group was significantly higher than that in the control group (P <0.05). There was no significant difference in the overall survival between the two groups (P> 0.05). Patients in both groups had hematological, digestive, neurotoxicity and radioactive lesions, all within tolerable range. There was no significant difference in the incidence of adverse reactions between the two groups (P <0.05). Conclusion TEGO capsule combined with three-dimensional conformal radiotherapy can reduce the CEA and CA19-9 levels in elderly patients with cardia cancer, which can effectively prolong the progression-free survival of patients with definite curative effect and is worthy of clinical application.