The effects of radiotherapy after thoracic and laparoscopic surgery on patients with esophageal cancer and on their prognoses.

OBJECTIVE: This paper aimed to explore the effects of radiotherapy after thoracic and laparoscopic surgery (TLS) in patients with esophageal cancer and on their prognoses.
METHODS: Altogether 118 patients with esophageal cancer diagnosed in our hospital were recruited as the study cohort and randomly divided into a postoperative radiotherapy group (59 cases) and a postoperative chemotherapy group (59 cases). All the patients were treated with TLS. In addition to the TLS, the patients in the postoperative radiotherapy group underwent radiotherapy, and the patients in the postoperative chemotherapy group were administered cisplatin and 5-fluorouracil (PF) chemotherapy. Before the treatment and at 6 months after the treatment, the serum carbohydrate antigen 199 (CA199), carbohydrate antigen 153 (CA153), and carcinoembryonic antigen (CEA) levels were measured using immunity transmission turbidity (ITT). The expression levels of Bax and Bcl-2 in the peripheral blood mononuclear cells (PBMCs) were measured using Western blot (WB). The CD4+, CD8+ and CD3+ levels in the peripheral venous blood were measured using a flow cytometer. The two groups were compared in terms of their effective treatment rates, their incidences of complications, and their postoperative survival rates.
RESULTS: After the treatment, the serum CEA, CA153, and CA199 levels in the postoperative radiotherapy group were significantly lower than they were in the postoperative chemotherapy group (P<0.05). After the treatment, the expression level of Bcl-2 was significantly lower in the postoperative radiotherapy group, but the Bax expression level was significantly higher in the postoperative radiotherapy group (P<0.05). After the treatment, there were no statistically significant differences in the CD4+, CD3+ or CD8+ levels between the two groups (P>0.05). After the treatment, the overall response rate (ORR) and the total incidence of adverse reactions were significantly higher in the postoperative radiotherapy group (P<0.05). After the treatment, the 1-year, 3-year, and 5-year survival rates were significantly elevated in the postoperative radiotherapy group (P<0.05).
CONCLUSION: Compared with the esophageal cancer patients treated with chemotherapy after TLS, the serum CA153, CA199, and CEA levels were significantly improved in the patients treated with radiotherapy. The Bcl-2 and Bax levels in the PBMCs tended close to normal. Therefore, undergoing radiotherapy after TLS is markedly effective in prolonging patients' survival times and improving their prognoses. AJTR