术后放化疗对淋巴结阳性食管鳞癌患者的临床意义  

Clinical Significance of Postoperative Radiation and Chemotherapy in Patients with Esophageal Squamous Carcinoma Positive-Lymph Node

作　　者：刘玉辉[1] 马楠[1] 陈哓夏 徐龙[1] 刘兆喆[1] 谢晓冬[1] 

机构地区：[1]沈阳军区总医院肿瘤科,辽宁沈阳110016

出　　处：《现代生物医学进展》2014年第34期6704-6706,共3页Progress in Modern Biomedicine

基　　金：2012年辽宁省科技攻关计划课题(2012225019)

摘　　要：目的:探讨术后放化疗在治疗淋巴结阳性食管鳞癌中的毒副作用、临床预后及可能影响因素。方法:选择淋巴结阳性食管鳞癌患者为研究对象,纳入研究患者共计64例,术后放疗剂量为50 Gy,化疗方案为顺铂联合紫杉醇(21 d方案),观察并记录患者不良反应情况,分析患者3年无瘤生存情况,并进一步探讨可能影响预后的相关因素。结果:患者出现骨髓抑制(白细胞下降),其中Ⅰ/Ⅱ度骨髓抑制39例(61.0%),Ⅲ/Ⅳ度骨髓抑制19例(29.7%);胃肠道反应Ⅰ/Ⅱ度15例(23.4%),Ⅲ/Ⅳ度6例(9.4%);无肝肾功能异常或明显过敏反应;Ⅰ/Ⅱ度放射性食管炎和放射性气管炎分别为18例(28.1%)和14例(21.9%),晚期肺损伤Ⅲ/Ⅳ度2例(3.1%)。64例患者的3年无瘤生存期为28.8个月,无瘤生存率为46.9%。本研究未发现明显影响术后放化疗治疗淋巴结阳性食管鳞癌患者预后的相关因素(P>0.05)。结论:淋巴结阳性食管鳞癌患者术后放化疗的不良反应主要为白细胞下降、胃肠道反应和放射性损伤等,患者均可耐受,且3年无瘤生存显著改善,可用于淋巴结阳性食管鳞癌患者治疗。Objective： To explore the side effects, clinical outcomes and possible influencing factors of postoperative chemoradiotherapy in treatment of lymph node positive esophageal squamous cell carcinomas. Methods： As research objects, the selected lymph node positive esophageal squamous carcinoma patients, in a total of 64 cases of patients, were given the postoperative radiotherapy dose of 50 Gy and chemotherapy regimens for cisplatin plus paclitaxel（21 d scheme）, and to observe and record adverse reactions, 3 year disease-free survival in patients and further exploring the related factors affecting the prognosis. Results： Patients performed with bone marrow suppression（a decrease in white blood cells）, including 39 cases（61.0%） of Ⅰ/Ⅱ and 19 cases（29.7%） of Ⅲ/Ⅳ degree of bone marrow inhibition; 15 cases（23.4%） of gastrointestinal reaction Ⅰ/Ⅱ degree, 6 cases（9.4%） of Ⅲ/Ⅳ degrees; without liver and kidney dysfunction or significant allergic reaction; 18 cases（28.1%） and 14 cases（21.9%） respectively of Ⅰ/Ⅱ degree of radioactive esophagitis and bronchitis, late lung injury Ⅲ / Ⅳ degree in 2 cases（3.1%）. Disease-free lifetime of 3 years in 64 cases was 28.8 months, and disease-free survival rate was 46.9%. The present study found no significant postoperative chemoradiotherapy treatment factors in relative to the prognosis of patients with lymph node positive esophageal squamous carcinoma（P0.05）. Conclusion： Postoperative chemoradiotherapy. in lymph node positive esophageal squamous carcinoma patients had adverse reactions tolerated mainly for white blood cells decline, gastrointestinal reaction and radiation damage, and improved the 3-year disease-free survival of patients, can be used in treating patients with lymph node positive esophageal squamous carcinoma.

关 键 词：食管鳞癌 淋巴结阳性 术后放化疗 

分 类 号：R735.1[医药卫生—肿瘤]