NP化疗联合调强放疗对子宫内膜癌患者HE4水平及疾病控制的影响

摘要

Objective To investigate the effect of NP chemotherapy combined with intensity modulated radiotherapy on HE4 level and disease control in patients with endometrial cancer. Methods 86 patients with endometrial cancer treated were randomly divided into two groups, 43 cases in each group. The control group received intensity-modulated radiation therapy, while the treatment group received NP chemotherapy combined with intensity-modulated radiation therapy. The short-term efficacy, side effects, long-term prognosis and HE4 level were compared. Results The effective rate (RR) of the treatment group was 90.70％, which was significantly higher than 65.12％ of the control group (P ＜ 0.05). The proportion of patients with leukopenia, thrombocytopenia and gastrointestinal reactions grade Ⅱ ～ Ⅳ in the treatment group was significantly lower than that in the control group (P ＜ 0.05). There was no significant difference between the other toxic and side effects groups (P＞ 0.05), and both groups were acceptable. The local recurrence rate (4.65％) in the treatment group was lower than that in the control group (18.60％) (P ＜ 0.05), while the distant metastasis rate (9.30％) and survival rate (90.70％) in the treatment group were not significantly different from those in the control group (11.63％, 79.07％) (P＞ 0.05); the HE4 level in the two groups after treatment was lower than that before treatment (P ＜ 0.05), and the treatment group was better than that before treatment (P ＜0.05). Conclusion NP chemotherapy combined with intensity modulated radiotherapy for endometrial cancer patients can significantly improve the short-term efficacy, effectively reduce the local recurrence rate of cancer, and play an anti-tumor role by lowering the level of HE4, and patients can tolerate toxic reactions.%目的 探讨NP化疗联合调强放疗对子宫内膜癌患者HE4水平及疾病控制的影响.方法 将86例子宫内膜癌患者随机分为2组,每组43例.对照组接受调强放疗,治疗组接受NP化疗联合调强放疗.比较近期疗效、不良反应、远期预后及HE4水平.结果 治疗组有效率 (RR) 达90.70％,明显较对照组的65.12％高 (P ＜0.05).治疗组白细胞减少、血小板下降、胃肠道反应Ⅱ～Ⅳ级发生率明显较对照组低 (P ＜0.05),其他不良反应组间比较无明显差异 (P＞ 0.05),且2组患者均可耐受.治疗组局部复发率 (4.65％) 较对照组 (18.60％) 低 (P ＜0.05);治疗组肿瘤远处转移率 (9.30％) 及生存率 (90.70％) 与对照组 (11.63％、79.07％) 比较,差异不明显 (P＞ 0.05).2组治疗后HE4水平均低于治疗前 (P ＜0.05),且治疗组较对照组低 (P ＜0.05).结论 对子宫内膜癌患者实施NP化疗联合调强放疗可显著提高近期疗效,有效降低肿瘤的局部复发率,同时能够通过下调HE4水平而起到抗肿瘤作用,且患者对不良反应均可耐受.