靶向放疗联合化疗改善局部复发性子宫内膜癌治疗的前瞻性研究-现代医学

靶向放疗联合化疗改善局部复发性子宫内膜癌治疗的前瞻性研究

单位：1. 西安交通大学第一附属医院肿瘤放疗科, 陕西西安 710061;
2. 延安市中医医院肿瘤科, 陕西延安 716000

分类号：R737.33

出版年·卷·期（页码）：2025·53·第一期（43-49）

摘要：

目的: 探究靶向放疗联合化疗在子宫内膜癌术后局部复发患者中的安全性和疗效。方法: 前瞻性地纳入2018年4月至2020年6月于西安交通大学第一附属医院收治的130例子宫内膜癌术后局部复发患者为研究对象，并将患者随机分为观察组和对照组，每组65例。对照组化疗治疗4个疗程，观察组盆腔调强放疗联合化疗治疗4个疗程。对比两组临床疗效、不良反应、治疗前后肿瘤标志物、生活质量和预后情况。结果: 观察组客观缓解率(ORR)为91.67%，对照组ORR为76.67%，观察组ORR显著高于对照组(χ²=10.086,P=0.024)。观察组胃肠道反应、骨髓抑制、皮肤损伤和周围神经病变的发生率与对照组比较，差异无统计学意义(均P>0.05)。治疗后观察组CA-125、CEA、HE4水平均显著低于对照组(均P<0.001)。治疗后观察组在癌症患者生命质量测定量表(FACT-G)的生理状况、社会/家庭状况、情感状况、功能状况4个维度评分均显著低于对照组(均P<0.001)。Kaplan-Meier曲线发现观察组3年存活率为72.31%，对照组3年存活率为52.31%，观察组显著高于对照组(P=0.009)。结论: 应用靶向放疗联合化疗一同干预子宫内膜癌术后局部复发患者，可以取得比单纯化疗更满意的疗效，且不会增加不良反应风险，能有效降低肿瘤标志物水平，提高患者生活质量和预后。

Objective: To explore the safety and efficacy of targeted radiotherapy combined with chemotherapy in the treatment of patients with local recurrence of endometrial cancer after surgery. Methods: From April 2018 to June 2020, 130 patients with local recurrence of endometrial cancer after surgery were prospectively enrolled in our hospital. The patients were randomly divided into an observation group and a control group, with 65 cases in each group. The control group was treated with chemotherapy for 4 courses, and the observation group was treated with pelvic intensity-modulated radiotherapy combined with chemotherapy for 4 courses. The clinical efficacy, adverse reactions, tumor markers, quality of life and prognosis were compared between the two groups before and after treatment. Results: The objective response rate(ORR) of the observation group was 91.67%, and that of the control group was 76.67%. The ORR of the observation group was significantly higher than that of the control group(χ²=10.086, P=0.024). The incidence rates of gastrointestinal reactions, bone marrow suppression, skin damage, and peripheral neuropathy in the observation group were not significantly different from those in the control group(all P>0.05). After treatment, the levels of carbohydrate antigen 125(CA-125),carcinoembryonic antigen(CEA), and human epididymis protein 4(HE4) in the observation group were significantly lower than those in the control group(all P<0.001). After treatment, the observation group had significantly lower scores than the control group in the four dimensions of the cancer patients' quality of life scale(FACT-G), including physical, social/family, emotional and functional well-beings(all P<0.001). The Kaplan-Meier curve showed that the 3-year survival rate of the observation group was 72.31%, and that of the control group was 52.31%, which was significantly higher than that of the control group(P=0.009). Conclusion: Targeted radiotherapy combined with chemotherapy can achieve more satisfactory results than chemotherapy alone without increasing the risk of adverse reactions in the treating patients with local recurrence of endometrial cancer after surgery. It can effectively reduce the level of tumor markers and improve the patients' quality of life and prognosis

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