ABSTRACT
Objective To compare the clinical effects and safety between laparoscope radical surgery after neoadjuvant chemoradiotherapy and traditional surgery alone for treatment of rectal cancer patients. Methods A total of 122 patients with rectal cancer from January 2013 to January 2015 in Qingdao Tumor Hospital were divided into the observation group (61 cases) and the control group (61 cases) according to the different therapies. The patients in the observation group received laparoscope radical surgery after neoadjuvant chemoradiotherapy, and the patients in the control group received laparoscope radical surgery of rectal carcinoma. The operative, pathological, immunological indicators and the complications were analyzed retrospectively. Results There were no statistical differences in conversion to open laparotomy rate [6.6 % (4/61) vs. 4.9 % (3/61)], anus preservation rate [80.3 % (49/61) vs. 67.2 % (41/61)], radical rate [77.0 % (47/61) vs. 85.2 % (52/61)] in the observation group and the control group (χ2: 0.152, 2.711, 1.339 respectively, all P > 0.05). The proportion of terminal ileum in the observation group was significantly higher than that in the control group [60.3 % (38/61) vs. 21.3 % (13/61), χ 2= 21.058, P < 0.05]; the number of cleaned lymph nodes in the observation group was significantly lower than that in the control group (8±5 vs. 15±7, t= 5.834, P < 0.05). There were no significant differences between before the treatment and 7 d after surgery of the two groups in the levels of T cells, CD4+, CD8+, CD4+/CD8+and natural kill cells (P > 0.05). There were no significant differences between the observation group(24.6 %)and the control group(27.9 %)in postoperative complication rates (P> 0.05). Conclusion Laparoscope radical surgery after neoadjuvant chemoradiotherapy can reduce the number of lymph nodes dissection with low incidence rate of postoperative complications and implicit impacts on immune system,which is safe and worthy of wide application.
ABSTRACT
Objective To investigate the expression of serum vascular endothelial growth factor (VEGF) in local advanced esophageal carcinoma patients,and to explore the relationship between its change rule and the recent curative effect and significance.Methods The serum levels of VEGF in 46 patients with local advanced esophageal carcinoma were detected by ELISA before and after concurrent chemoradiotherapy,the serum levels of VEGF in 46 healthy people were detected at the same time.Results The serum VEGF levels of local advanced esophageal carcinoma patients before treatment and health control group were (264.66±62.11) ng/L and (101.96±39.53) ng/L,and the difference was statistically significant (t =23.367,P =0.000).After treatment,the serum VEGF level of patients with esophageal cancer was decreased to (127.50±49.07) ng/L (t =19.086,P =0.000).After the treatment,the serum VEGF levels of complete remission (CR) and partial remission (PR) patients were decreased [(94.03±38.86) ng/L vs (248.79±47.84) ng/L,(117.06±20.68) ng/L vs (295.26±67.20) ng/L,both P =0.000],the level of the stable disease (SD) patients was decreased,too [(235.63±26.05) ng/L vs (385.67±26.50) ng/L,P =0.017].Conclusions The recent curative effects of docetaxel and nedaplatin chemotherapy combined with intensity-modulated radiotherapy for the local advanced esophageal carcinoma patients are significant.The levels of serum VEGF before and after treatment can be used as an important index to judge the treatment effect.