Abstract: Objective　To investigate the efficacy of cetuximab combined with three-dimensional conformal radiotherapy in the treatment of advanced esophageal cancer and its influence on serum tumor markers levels, neovascularization indexes levels, and survival. Methods　A total of 106 patients with advanced esophageal cancer admitted to Nanyang First People's Hospital from January 2020 to August 2021 was selected as the research objects. After analyzing the patients' medical records, the patients were divided into a control group and an observation group according to different treatment options, with 53 cases in each group. The control group received three-dimensional conformal radiotherapy, and the observation group received cetuximab combined with three-dimensional conformal radiotherapy. The control group included 30 females and 23 males, aged (58.69±1.28) years; the observation group included 31 females and 22 males, aged (57.96±1.32) years. The therapeutic efficacy, serum tumor markers levels [carbohydrate antigen 125 (CA125), cytokeratin protein fragment 19 (CYFA21-1), and serum carcinoembryonic antigen (CEA)], neovascularization indexes levels [transforming growth factor β1 (TGF-β1) and vascular endothelial growth factor (VEGF)], survival status, and adverse reactions were compared between the two groups. The measurement data were tested by independent sample t test and the count data were tested by χ² test. Results　The total effective rate of the observation group was 75.47% (40/53), higher than 49.06% (26/53) in the control group (P<0.05). There were no statistically significant differences in the serum tumor markers between the two groups before treatment (all P>0.05), and the levels of CA125, CYFA21-1, and CEA in the observation group were lower than those in the control group after treatment (all P<0.05). There were no statistically significant differences in TGF-β₁ and VEGF between the two groups before treatment (both P>0.05), and the levels of TGF-β1 and VEGF in the observation group were lower than those in the control group after treatment (both P<0.05). The survival rate of the observation group (60.38%, 32/53) was higher than that of the control group (37.74%, 20/53) (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the observation group (18.87%, 10/53) and the control group (22.64%, 12/53) (P>0.05). Conclusion　Cetuximab combined with three-dimensional conformal radiotherapy for patients with advanced esophageal cancer can significantly improve their levels of serum tumor markers and neovascularization indicators, increase the survival rate, which is safe and effective.

Key words: Esophageal cancer, Cetuximab, Three-dimensional conformal radiotherapy, Serum tumor markers, Neovascularization, Adverse reactions

摘要： 目的　探讨西妥昔单抗联合三维适形放疗在中晚期食管癌患者中的疗效及对血清肿瘤标志物水平、新生血管指标水平、生存情况的影响。方法　回顾性分析选取南阳市第一人民医院2020年1月至2021年8月收治的106例中晚期食管癌患者作为研究对象，分析患者的病历资料后，根据治疗方案的不同将患者分对照组和观察组各53例。对照组接受三维适形放疗治疗，观察组接受西妥昔单抗联合三维适形放疗治疗。对照组患者女性30例、男性23例，年龄（58.69±1.28）岁；观察组女性31例、男性22例，年龄（57.96±1.32）岁。比较两组患者治疗效果、血清肿瘤标志物水平［糖类抗原125（carbohydrate antigen 125，CA125）、细胞角化素蛋白片段19（cytokeratin protein fragment 19，CYFA21-1）、血清癌胚抗原（serum carcinoembryonic antigen，CEA）］、新生血管指标水平［转化生长因子β1（transforming growth factor β1，TGF-β1）、血管内皮生长因子（vascular endothelial growth factor，VEGF）］、生存状况、不良反应等。计量资料组间用独立样本t检验，计数资料组间用χ²检验。结果　观察组治疗总有效率75.47%（40/53）高于对照组49.06%（26/53）（P<0.05）。治疗前两组患者血清肿瘤标志物差异均无统计学意义（均P>0.05），治疗后观察组CA125、CYFA21-1、CEA水平低于对照组（均P<0.05）。两组患者治疗前TGF-β1、VEGF指标差异均无统计学意义（均P>0.05），治疗后观察组TGF-β1、VEGF低于对照组（均P<0.05）。观察组生存率60.38%（32/53）高于对照组37.74%（20/53）（P<0.05）。观察组不良反应发生率18.87%（10/53）与对照组22.64%（12/53）比较差异无统计学意义（P>0.05）。结论　中晚期食管癌患者接受西妥昔单抗联合三维适形放疗治疗，可显著改善其血清肿瘤标志物水平、新生血管指标，提高生存率，安全有效。

关键词: 食管癌, 西妥昔单抗, 三维适形放疗, 血清肿瘤标志物, 新生血管, 不良反应