Effects of short-term preoperative radiotherapy combined with PD-1 monoclonal antibody on serum SDC2 levels in locally advanced elderly rectal cancer
Wen Jing
Yang Li
Zhang Wei
Xu Qiong
Wu Qian
Fang Chengxiang
Abstract：Objective To investigate the clinical efficacy of preoperative short-course radiotherapy(SCRT)combined with anti-programmed death receptor-1(PD-1)monoclonal antibody in elderly patients with locally advanced rectal cancer.Methods A retrospective study was conducted on rectal cancer patients admitted to Minda Hospital Affiliated to Hubei Min-zu University from June 2021 to June 2024.After screening,80 patients were enrolled and divided into an observation group(n=40)and a control group(n=40).The observation group received SCRT(25 Gy/5 fractions over 5 days)combined with tirelizumab(200 mg intravenous infusion on day 1,repeated every 3 weeks for 2 cycles)followed by radical surgery.The con-trol group underwent radical surgery 8 to 12 weeks after SCRT alone.Perioperative indicators,disease remission rates,and postoperative complications were compared between the two groups.Results The positive rate of serum SDC2 decreased sig-nificantly after surgery in both groups compared to preoperative levels(P＜0.05).The observation group showed a significantly greater reduction in SDC2 expression than the control group(x2=5.59,P=0.018).Postoperative levels of CD3+,CD4+,and CD4+/CD8+decreased significantly in both groups(all P＜0.05),but these levels were significantly higher in the observation group than in the control group(P＜0.05).No significant differences were observed in operative duration,intraoperative blood loss,time to first flatus,time to first bowel movement,duration of abdominal drainage,or length of hospital stay(all P＞0.05).The objective response rate did not differ significantly between the observation and control groups(75.00％vs.62.50％,x2=1.455,P=0.228),but the disease control rate was significantly higher in the observation group(95.00％vs.77.50％,x2=5.165,P=0.023).Postoperative complication rates were comparable between the two groups(15.00％vs.17.50％,x2=0.092,P=0.762).Conclusion Preoperative SCRT combined with PD-1 monoclonal antibody can effectively improve disease control rates,reduce serum SDC2 positivity,and enhance immune function without compromising surgical safety in elderly patients with locally advanced rectal cancer.
Keywords：Advanced elderly rectal cancerShort-course radiotherapyAnti-programmed death receptor-1SDC2Therapeutic effectElderly
Publication Date：2025-11-18
Online Publishing Date：2025-12-05(First online date of this platform, not the publication date of the document)
Pages：6( 1323-1328 )