术前同步放化疗联合手术治疗局部晚期食管癌的疗效评价  

Clinical analysis of preoperative concurrent radiotherapy and chemotherapy combined with operation in treatment of locally advanced esophageal cancer

作　　者：李学健[1,2] 贾慧[2] 宋平平[2] 李广旭[2] 张曙光[2] 张百江[2] 

机构地区：[1]济南大学山东省医学科学院医学与生命科学院,山东济南250117 [2]山东省肿瘤医院,山东济南250117

出　　处：《中国肿瘤外科杂志》2014年第2期77-79,92,共4页Chinese Journal of Surgical Oncology

基　　金：山东省自然青年科研基金资助(ZR2012HL37)

摘　　要：目的 探讨术前同步放化疗联合手术治疗局部晚期食管癌的临床疗效。方法 选取2008年1月至2011年12月局部晚期食管癌患者68例，研究组38例患者给予多西他赛75mg/m2，第1天静滴，顺铂30mg/m2，第1-3天静滴，21天为1周期，并行同步三维适形放疗，化疗结束后2周手术。对照组患者30例直接手术。结果 全组病例无手术死亡，术后并发症发生率差异无统计学意义。研究组患者完全性切除率为94.7%（36/38），对照组完全性切除率73.3%（22/30），两组差异具有统计学意义（P＜0.05）。研究组和对照组1、2、3年生存率分别为89.5%、55.3%、42.1%和66.7%、30.0%、16.7%，研究组1、2、3年生存率均显著高于对照组，差异均具有统计学意义（P＜0.05）。结论 局部晚期食管癌术前应用多西他赛和顺铂同步放化疗可降低食管癌临床分期，提高完全性切除率，并且可提高术后1、2、3年生存率。Objective To evaluate the efficacy of chemoradiotherapy followed by surgery and surgery alone for locally advanced esophageal cancer. Methods From January 2008 to December 2011, 68 consecutive pa- tients with local advanced esophageal cancer were entered into this study and were divided into two groups. 38 patients were treated with chemotherapy which consisted of docetaxel 75 mg/m2, D1 and cisplatin 30 mg/m2, D1-3 intravenous drip, 21 d for ] cycle and three-dimensional conforma] radiotherapy（DCRT）. After completion of chemotherapy, these patients underwent surgery. Other 30 patients directly underwent surgery. Results There was no death case and no significant difference in the operation-related complications rate be- tween two groups. The complete-resection-rates of experimental group were 94.7% （36/38） and 73.3% （22/ 30） in control group, respectively. The complete-resection-rates of experimental group were were much better than those in control group（P 〈0.05）. The 1-,2-,3-year survival rates were 89.5% , 55.3% , 42.1% in ex- perimental group and 66.7% , 30.0% , 16.7% in control group, respectively. The survival rates of experimen- tal group were much better than those in control group （ P 〈 0.05 ）. Conclusions Preoperative chemoradiotherapy is able to significantly reduce tumor stage, and achieve substantially complete-resection-rate during opera- tion and 1-,2-,3-year survival rate after operation.

关 键 词：食管癌 局部晚期 同步放化疗 外科治疗 生存率 

分 类 号：R735.1[医药卫生—肿瘤]