新辅助放化疗续贯手术治疗局部进展期食管鳞癌临床观察  

Clinical observation of neoadjuvant radiotherapy and chemotherapy followed by surgery in treatment of locally advanced esophageal squamous cell carcinoma

作　　者：杨晓利[1] 王彩玲[1] 王俊生[1] YANG Xiao-li;WANG Cai-ling;WANG Jun-sheng(Department of Sixth Internal Medicine,Anyang Tumor Hospital,Anyang 455000,China)

机构地区：[1]安阳市肿瘤医院内六科,河南安阳455000

出　　处：《社区医学杂志》2022年第7期384-388,共5页Journal Of Community Medicine

摘　　要：目的评价不同新辅助治疗方法对局部进展期食管鳞癌的疗效及安全性。方法回顾性分析2017-05-01-2018-05-31安阳市肿瘤医院收治的50例局部进展期采取新辅助治疗后手术的食管鳞癌患者的临床资料,按术前新辅助治疗方案分为2组,同步放化疗组为A组,单纯的化疗组为B组,新辅助治疗后3~6周行手术治疗,术前应用实体瘤的疗效评价标准(RECIST)评价2组有效率,术后观察比较2组患者手术R0切除率、病理完全缓解率(pCR)、围手术期并发症发生率及无疾病生存时间(DFS)。结果2组患者客观有效率分别为96.15%和91.66%,差异无统计学意义,χ^(2)=0.005,P=0.943;2组患者均达到R0切除,A组pCR为46.15%,明显高于B组的0,差异有统计学意义,χ^(2)=14.575,P=0.001。A组患者DFS为20.7个月,长于B组的19.2个月,差异有统计学意义,χ^(2)=4.173,P=0.041。在术前新辅助治疗不良反应方面及术后并发症发生率等方面2组差异无统计学意义,但A组术后并发症食管瘘、肺部感染及心律失常发生率高于B组。结论对于局部进展期食管鳞癌,新辅助放化疗和新辅助化疗短期有效率及安全性相当,但新辅助同步放化疗在pCR及DFS方面更优。Objective To evaluate the efficacy and safety of different neoadjuvant treatments for locally advanced esophageal squamous cell carcinoma.Methods A total of 50 patients with esophageal squamous cell carcinoma who underwent surgery after neoadjuvant therapy in locally advanced stage in Anyang Tumor Hospital from May 1,2017 to May 31,2018 were retrospectively analyzed.They were divided into two groups according to the preoperative neoadjuvant therapy scheme.The synchronous radiotherapy and chemotherapy group was group A and the simple chemotherapy group was group B.The operation was performed 3-6 weeks after neoadjuvant therapy.The response evaluation criteria in solid tumours(RECIST)was used to evaluate the effective rate of the two groups before operation,The R0 resection rate,pathological complete remission rate(pCR),perioperative complication rate and disease-free survival(DFS)time were observed and compared between the two groups.Results The objective effective rates of the two groups were 96.15%and 91.66%respectively,with no significant difference,χ^(2)=0.005,P=0.943.R0 resection was achieved in both groups.The pCR of group A was 46.15%,which was significantly higher than that of group B,χ^(2)=14.575,P=0.001.DFS in group A was 20.7 months,which was longer than 19.2 months in group B(χ^(2)=4.173,P=0.041).There was no significant difference between the two groups in the adverse reactions of preoperative neoadjuvant therapy and the incidence of postoperative complications,but the incidence of postoperative complications such as esophageal fistula,pulmonary infection and arrhythmia in group A was higher than that in group B.Conclusion For locally advanced esophageal squamous cell carcinoma,neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy have the same short-term efficiency and safety,but neoadjuvant concurrent chemoradiotherapy is better in pCR and DFS.

关 键 词：食管鳞癌 新辅助放化疗 新辅助化疗 病理完全缓解 

分 类 号：R735.1[医药卫生—肿瘤]