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| Effectiveness of Different Radiotherapy Regimens Combined with Surgery in the Treatment of Medium to Low Locally Progressive Rectal Cancer and the Effect on Tumor Markers |
| WU Renrui, ZHONG Qiong, HUANG Rong |
| First-author's address: Ganzhou People's Hospital, Jiangxi Province, Ganzhou 341000, China |
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Abstract Objective: To investigate the effect of intensity-modulated radiotherapy combined with surgery for medium to low locally progressive rectal cancer and the effect on tumor markers. Method: Ninety-eight patients with medium to low locally progressive rectal cancer treated in Ganzhou People's Hospital from January 2019 to January 2020 were selected and divided into observation group and control group using the random number table method, with 49 cases each. Both groups received laparoscopic radical rectal cancer treatment, and the control group was treated with neoadjuvant radiotherapy before surgery, while the observation group was treated with full neoadjuvant therapy before surgery. The near and long-term efficacy, complication rate, serum tumor marker levels and immune function indexes of the two groups were compared. Result: The objective remission rate of the observation group was higher than that of the control group (P<0.05), and the 2-year local recurrence rate and distant metastasis rate were lower than those of the control group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Before treatment, the levels of serum tissue polypeptide specific antigen (TPS), cytokeratin 19 fragment (CYFRA21-1), fatty acid synthase (FAS) and tumor-type M2 pyruvate kinase (TuM2-PK) were not significantly different between the two groups (P>0.05); after treatment, the levels of each index were reduced in both groups, and the observation group were lower than those of the control group (P<0.05). Before treatment, the levels of CD3+, CD4+ and CD8+ in the two groups were not significantly different compared (P>0.05); after treatment, the levels of CD3+ and CD4+ decreased in both groups, but the observation group were higher than those of the control group (P<0.05), and CD8+ increased in both groups, but the observation group was lower than that of the control group (P<0.05). Conclusion: Full neoadjuvant treatment for middle to low locally progressive rectal cancer before laparoscopic radical resection of rectal cancer has significant near and long-term effects, without increasing complications, and can significantly reduce the level of serum tumor markers, with a low degree of damage to immune function.
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Received: 21 April 2023
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