局部晚期食管下段癌术前动脉灌注化疗临床疗效观察  

Clinical effects of preoperative intra-arterial infusion chemotherapy for local advanced lower esophageal carcinoma

作　　者：刘厚斌[1] 袁光金[1] 李向阳[1] 丁友宏 邱亮[1] 

机构地区：[1]解放军第82医院肿瘤中心,江苏淮安223001

出　　处：《现代肿瘤医学》2013年第3期524-526,共3页Journal of Modern Oncology

摘　　要：目的:探讨局部晚期食管下段癌术前动脉灌注化疗的临床疗效。方法:64例局部晚期食管下段癌患者随机分为两组:术前灌注化疗组及直接手术组。前者术前行选择性动脉灌注化疗:表柔比星60-80mg,顺铂40-60mg,5-FU 750-1000mg。化疗后2周左右接受手术治疗。观察动脉灌注化疗不良反应、组织学疗效,并比较两组手术切除率及手术并发症。结果:动脉灌注化疗不良反应主要表现为胃肠道反应和骨髓抑制,均为Ⅱ度以下。灌注化疗组手术切除率为100%,R0切除率为87.5%(28/32),均高于直接手术组(P<0.05),后者手术切除率为78.1%(25/32),R0切除率为62.5%(20/32)。术后并发症两组之间无统计学差异(P>0.05)。术前灌注化疗组术后病理分期较术前降低,其中II期病例明显增多。结论:局部晚期食管下段癌术前选择性动脉灌注化疗可降低临床分期,提高手术切除率。Objective：To evaluate the clinical effect of preoperative intra - arterial infusion chemotherapy in pa- tients with local advanced lower esophageal carcinoma. Methods： Sixty - four patients with local advanced lower e- sophageal carcinoma were randomly divided into 2 groups：preoperative intervention group and direct surgery group. The former received preoperative intra - arterial infusion with epirubicin 60 - 80mg, cisplatin 40 - 60mg and 5 - FU 750 - 1000mg, and surgery was performed about 2 weeks later. The toxicity or complication of infusion chemotherapy, and histological response were investigated. The resection rates and surgery complications were compared between the two groups. Results：The main toxicities of intra - arterial infusion chemotherapy were gastrointestinal reactions and bone marrow suppression in grade I - II. The resection rates and RO resection rat were 100% and 87.5% （28/32） in preoperative intervention group, respectively;both of them were higher than those in direct surgery group [ 78.1% （ 25/32 ） ,62.5 % % （ 20/32 ） ] （ P 〈 0.05 ）. There were no differences noted between the two groups in the postoper- ative complications （P 〉 0.05 ）. Histological response was observed after preoperative intra - arterial infusion chemo- therapy, as evidenced by increased stage II cases compared with direct surgery group. Conclusion： Preoperative intra -arterial infusion chemotherapy is helpful to improve the resection rate and downstage the tumor.

关 键 词：局部晚期食管下段癌 动脉灌注化疗 手术 

分 类 号：R735.1[医药卫生—肿瘤]