同步放化疗治疗局限性肛管鳞癌的疗效分析

Efficacy analysis of concurrent chemoradiotherapy in patients with localized anal squamous cell carcinoma

摘要:

目的 探讨同步放化疗治疗局限性肛管鳞癌患者的临床疗效及营养状况。方法 回顾性分析2018年1月—2023年12月湖南省肿瘤医院收治的41例局限性肛管鳞癌患者的病历资料。患者采用同步放化疗治疗，分析该方案的疗效、生存情况、不良反应及营养状况。采用描述性统计分析完全缓解（CR）构成比及不良反应构成比，采用χ²检验分析临床参数与治疗疗效的关系，采用Kaplan-Meier法估算3年总生存（OS）率及无进展生存（PFS）率，采用独立样本t 检验分析同步放化疗前后的营养状况。结果 接受PF方案同步放化疗的局限性肛管鳞癌患者的CR构成比、部分缓解构成比、疾病稳定构成比、疾病进展构成比分别为90.2%、4.9%、2.4%、2.4%；3年OS率和3年PFS率分别为88.1%和81.1%。最常见的治疗相关3级不良事件及发生率为：放射性皮炎25例（61.0%）、白细胞减少8例（19.5%）、中性粒细胞减少8例（19.5%）。与放疗前相比，放疗后患者的血红蛋白、白蛋白和淋巴细胞计数均降低（P <0.05）；放疗前后体重和体质量指数比较，差异均无统计学意义（P >0.05）。结论 PF方案同步放化疗治疗局限性肛管鳞癌可取得令人满意的疗效，且毒性可接受。

Abstract:

Objective To investigate the clinical efficacy of concurrent chemoradiotherapy in patients with localized anal squamous cell carcinoma and their nutritional status.Methods Clinical data of 41 patients with localized anal squamous cell carcinoma admitted to Hunan Cancer Hospital from January 2018 to December 2023 were retrospectively analyzed. The patients were treated with concurrent chemoradiotherapy. The efficacy and treatment-related adverse reactions as well as survival and nutritional status of patients were analyzed. Descriptive statistical analysis was used to determine the proportion of complete remission (CR) and adverse reactions. The Chi-square ( χ2 ) test was employed to analyze the relationship between clinical parameters and treatment efficacy. The Kaplan-Meier method was used to estimate the 3-year overall survival (OS) rate and progression-free survival (PFS) rate. An independent sample t-test was conducted to assess the nutritional status before and after concurrent chemoradiotherapy.Results The proportions of CR, partial response (PR), stable disease (SD) and progressive disease (PD) in patients with localized anal squamous cell carcinoma who received concurrent chemoradiotherapy with the PF regimen were 90.2%, 4.9%, 2.4%, and 2.4%, respectively. The 3-year OS and PFS rates were 88.1% and 81.1%, respectively. The most common treatment-related grade 3 adverse events and their incidence rates were 25 cases of radiation dermatitis (61.0%), 8 cases of leukopenia (19.50%), and 8 cases of neutropenia (19.5%). After concurrent chemoradiotherapy, the levels of hemoglobin (Hb), serum albumin (Alb), and lymphocytes (Lym) were significantly lower than those before treatment (P < 0.05). There was no significant difference in weight and body mass index (BMI) before and after concurrent chemoradiotherapy.Conclusions Concurrent chemoradiotherapy with the PF regimen can achieve satisfactory therapeutic effects for localized anal squamous cell carcinoma, and the toxicity is acceptable.