5-FU与顺铂辅助放化疗预防食管鳞癌微转移的临床观察  

Clinical Observation of Prevention of Esophageal Squamous Cell Cancer Micrometastases with Neoadjuvant Chemoradiotherapy Applied by 5-FU and Cisplatin

作　　者：郁大江[1] 

机构地区：[1]江苏省中医院心胸外科南西六病区,江苏南京210029

出　　处：《辽宁医学院学报》2014年第1期38-41,共4页Journal of Liaoning Medical University (LNMU) Bimonthly

摘　　要：目的探讨应用5-氟尿嘧啶(5-FU)与顺铂术前辅助放化疗预防食管鳞癌微转移的临床疗效,为临床提供参考。方法将127例食管鳞癌患者分为两组,对照组63例行单纯手术治疗,观察组64例在手术前辅助应用5-FU与顺铂化疗2个周期后,行食管区放射治疗,放化疗结束后3 w再行手术治疗。对比考察两组患者术后外周血CK19 mRNA的阳性表达率;同时对比两组的根治切除率与术后生存率。结果观察组和对照组的外周血中CK19 mRNA阳性表达率分别为:31.74%和23.08%,两组比较,差异具有统计学意义(P<0.05);观察组根治切除率显著高于对照组(P<0.05);观察组术后1、2和3年生存率分别为:85.94%、67.19%和43.74%;对照组分别为:80.95%、41.27%和25.40%;两组比较,术后1年生存率差异无统计学意义(P>0.05),观察组术后2年和3年生存率显著高于对照组(P<0.05)。结论食管癌患者手术前辅助应用5-FU与顺铂化疗及食管区放疗,可良好预防微转移的发生。Objective To explore clinical efficacy of prevention of esophageal Squamous cell cancer micrometastases with preop- erative neoadjuvant chemoradiotherapy applied by 5 - FU and cisplatin, and to provide a reference for clinical. Methods In our hos- pital, 127 patients with esophageal squamous cell cancer were divided into 2 groups. 63 patients of control group were treated with sur- gery, while 64 patients of observation group were treated with preoperative chemotherapy for 2 cycles applied by 5 - FU and cisplatin, and then were treated with radiation therapy on the esophageal district, and finally were treated with surgery after the end of chemora- diotherapy for 3 weeks. The positive expression rate of peripheral blood CK19 of mRNA after operation of the two groups was compared and studied. At the same time, the radical resection rate and survival rate of the two groups were compared. Results The positive ex- pression rate of CK19 mRNA in peripheral blood in the observation group and control group were 31.74% and 23. 08% respectively, and the differences were statistically significant （ P 〈 0. 05）. The radical resection rate in observation group was obviously higher than that in control group （P 〈0. 05）. The survival rate after operation after 1,2 and 3 years was 85.94%, 67. 19% and 43.74% respec- tively in observation group, and it was 80. 95%, 41.27% and 25.40% respectively in control group. The differences were not statisti- cally significant after operation after 1 year （ P 〉 0. 05 ）. The survival rate after operation in observation group was obviously higher than that in control group after 2 ＇and 3 years （ P 〈 0. 05 ）. Conclusion To apply esophageal 5 - FU and cisplatin with preoperative neoad- juvant chemoradiotherapy to squamous cell cancer patients can prevent micrometastases effecti~,ely.

关 键 词：食管癌 微转移 放化疗 5-FU 顺铂 

分 类 号：R735.1[医药卫生—肿瘤]