术前放化疗与单纯手术治疗食管鳞癌的随机对照研究  

Randomized controlled study on preoperative concurrent chemoradiotherapy versus surgery alone for esophageal squamous cell carcinoma

作　　者：彭林[1] 谢天鹏[1] 韩泳涛[1] 郎锦义[1] 李涛[1] 付彬玉[1] 陈利华[1] 方强[1] 

机构地区：[1]四川省肿瘤医院胸外科,成都610041

出　　处：《肿瘤》2008年第7期620-622,共3页Tumor

摘　　要：目的:评价食管癌术前同期放化疗的有效性和安全性,以及对提高生存率的价值。方法:对术前临床分期为ⅡB、Ⅲ期,无外科手术和放化疗禁忌证的80例食管癌患者进行随机分组:综合治疗组和对照组各40例。综合治疗组,40例患者术前采用新辅助放化疗(5-氟尿嘧啶+顺铂)2个周期,同期进行放疗,直线加速器放射治疗(剂量40Gy),放化疗结束后3～5周手术切除;对照组则采用单纯手术治疗。采用SPSS11.10软件进行χ2检验和生存率分析。结果:综合治疗组和对照组的根治性切除率分别为97.5%和90%;综合治疗组TNM分期比对照组明显降低;术后并发症2组发生率无明显差异,综合治疗组生存率明显优于对照组。结论:术前辅助性放化疗能显著提高食管癌根治性切除率,提高生存率,降低TNM分期和区域淋巴结转移,减少局部复发和远处转移。Objective：This study was performed to assess the efficacy and safety of preoperative concurrent chemotherapy and radiotherapy for esophageal cancer and its value in improving survival rate. Methods： Eighty patients at Ⅱ B and Ⅲ clinical stages and without contraindications for surgery and radiochemotherapy were selected in the study. They were randomly assigned into two groups with 40 patients in each group. Patients in combined therapy group were given two cycles of neoadjuvant chemotherapy （ 5-fluorouracil 500 mg/m^2 ＋ cisplatin 75 mg/m^2 ） and the concurrent radiotherapy. Linear accelerator machine produced radiation at the dosage of 40 Gy. The tumor was resected at 3-5 weeks after concurrent chemotherapy and radiotherapy. Patients in the control group received surgery alone. SPSS software was used to performx2 test and make survival rate analysis. Results： The radical resection rates were 97.5% and 90% in the combined therapy group and control group, respectively. TNM staging was significantly decreased in the combined therapy group than that in the control group; there was no significant difference in the incidence of postoperative complications between the two groups. The postoperative survival rate of the combined therapy group was significantly higher than that of the control group. Conclusion： Preoperative adjuvant chemoradiotherapy markedly increased the radical resection rate and survival rate, decreased the TNM staging and regional lymph node metastasis, and suppressed local recurrence and distal metastasis.

关 键 词：食管肿瘤 抗肿瘤联合化疗方案 外科手术 

分 类 号：R735.1[医药卫生—肿瘤]