调强放射治疗未分化型鼻咽癌的疗效及治疗前后血清sE-cad与PDGF水平变化探讨

Efficacy of intensity-modulated radiation therapy in the treatment of undifferentiated nasopharyngeal carcinoma and the changes of serum sE-cad and PDGF levels before and after treatment

摘要:

目的 探究调强放射治疗(IMRT)未分化型鼻咽癌(NPC)的临床疗效及患者治疗前后血清上皮型钙黏蛋白(sE-cad)、血小板源性生长因子(PDGF)水平变化。方法 选取2019年6月—2021年6月收治的84例未分化型NPC患者作为研究对象，按照随机数字表法按1∶1比例分为观察组和对照组，每组各42例，对照组采用三维适形放射治疗(3DCRT)，观察组采用IMRT治疗。治疗7周后比较两组患者临床疗效，治疗前与治疗7周后肿瘤标志物水平[癌胚抗原(CEA)、鳞状细胞癌相关抗原(SCC-Ag)、角蛋白19片段21-1(CYFRA21-1)]，生活质量核心量表(QLQ-C30)评分，纤维化指标[透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)]，血清sE-cad、PDGF水平及治疗期间并发症发生率。结果 治疗7周后，观察组疾病控制率95.24%，显著高于对照组的80.95%(P＜0.05)；观察组血清CEA、SCC-Ag、CYFRA21-1水平较对照组低(P＜0.05)；观察组QLQ-C30评分较对照组低(P＜0.05)；观察组血清HA、LN、PCⅢ水平较对照组低(P＜0.05)；观察组血清sE-cad、PDGF水平较对照组低(P＜0.05)；观察组并发症发生率较对照组低(P＜0.05)。结论 与3DCRT相比，采用IMRT治疗未分化型NPC可有效降低肿瘤标志物及血清sE-cad、PDGF水平，提高生活质量，疗效显著，且对正常组织影响更小，安全性高。

Abstract:

Objective To explore the efficacy of intensity-modulated radiation therapy (IMRT) in the treatment of undifferentiated nasopharyngeal carcinoma (NPC), and to observe changes of serum epithelial cadherin (sE-cad) and platelet-derived growth factor (PDGF) before and after treatment.Methods A total of 84 patients with NPC (undifferentiated type) admitted to our hospital from June 2019 to June 2021 were selected as the research objects, and divided into observation group and control group by random number table method according to the ratio of 1∶1, with 42 cases in each group. The control group was treated with 3-dimensional conformal radiation therapy (3DCRT), and the observation group was treated with IMRT. Comparisons between the two groups were performed on efficacy, changes of sereum levels tumor markers [carcinoembryonic antigen (CEA), squamous cell carcinoma-associated antigen (SCC-Ag), keratin 19 fragment 21-1, CYFRA21-1)], quality of life questionnaire core 30 (QLQ-C30) score, fibrosis indicators [hyaluronic acid (HA), laminin (LN), procollagen type III (PCIII), sE-cad, and PDGF after 7 weeks of treatment, as well as complication rates during treatment.Results After 7 weeks of treatment, the disease control rate in the observation group was 95.24%, which was significantly higher than that in the control group of 80.95% (P＜0.05). Meanwhile, the serum levels of CEA, SCC-Ag and CYFRA21-1, the QLQ-C30 score, the serum levels of HA, LN, PCIII and the serum sE-cad and PDGF levels in the observation group were lower than those in the control group, respectively (all P＜0.05). The incidence of complications in the observation group was also lower than that in the control group (P＜0.05).Conclusion Compared with 3DCRT, IMRT treatment of undifferentiated NPC can effectively reduce serum levels of tumor markers and serum sE-cad and PDGF levels, improve quality of life, have significant efficacy, and have less impact on normal tissues with high safety.