新辅助放化疗联合手术治疗晚期食管癌的临床疗效  

Clinical efficacy of neoadjuvant chemotherapy combined surgery in treatment of advanced esophageal cancer

作　　者：魏起友[1] 韩巴特尔[1] 赵德惠[1] 李文渊[1] 

机构地区：[1]内蒙古医科大学附属人民医院胸外科,内蒙古呼和浩特010020

出　　处：《中国医药科学》2015年第7期9-11,15,共4页China Medicine And Pharmacy

基　　金：内蒙古自治区科技计划项目(20100501)

摘　　要：目的比较新辅助放化疗联合手术治疗晚期食管癌与单纯手术治疗的临床疗效。方法回顾性分析晚期食管癌患者60例的临床资料,根据患者的治疗方法分为联合治疗组33例和单纯手术组27例。联合治疗组采用新辅助放化疗联合手术的方法治疗。比较两组患者手术并发症,术后1、2、3年生存率。结果联合组出现新辅助放化疗不良反应主要为放射性食管炎、放射性肺炎、血液学毒性、消化道症状。联合组总的手术并发症高于单纯手术组,但是两组比较差异无统计学意义(P>0.05)。联合组完整切除率93.9%,显著高于单纯手术组(P<0.05),随访期间联合组局部复发率及总的复发转移率均显著低于单纯手术组(P<0.05或<0.01)。联合组2年生存率78.8%,3年生存率60.6%,显著高于单纯手术组(P均<0.05)。结论新辅助放化疗联合手术治疗晚期食管癌能够显著提高完整切除率,减少局部转移以及总的转移复发率,改善3年生存率,值得临床推广。但临床上应根据患者情况,筛选潜在的获益患者,避免发生过度治疗。ObjectiveTo discuss clinical efficacy of neoadjuvant chemotherapy combined surgery in treatment of advanced esophageal cancer.Methods 60 cases with advanced esophageal cancer were respectively analyzed, and divided into combination therapy group 33 cases and surgery alone group 27 cases. Combination therapy group was treated with neoadjuvant chemotherapy combined with surgery. Complications and survival rates after 1 year, 2 years, 3 years of two groups were compared.ResultsNeoadjuvant chemotherapy side effects of combination therapy group were esophagitis, radiation pneumonitis, hematological toxicity, gastrointestinal symptoms. Surgical complications rate of combination therapy group was higher than surgery alone group, but with no significant difference（P〉0.05）. Complete resection rate of combination therapy group was 93.9%, which was higher than surgery alone group（P〈0.05）; The local recurrence rate and the overall recurrence rate of combination therapy group were lower than surgery alone group（P〈0.05 or 〈0.01）. Two-year survival rate of combination therapy group was 78.8%, and 3-year survival rate was 60.6%, which were higher than surgery alone group（allP〈0.05）. Conclusion Complete resection rate is improved, the local recurrence rate and the overall recurrence rate are reduced, and 3-year survival rate is improved with neoadjuvant chemotherapy combined surgery in treatment of advanced esophageal cancer, worthy of clinical promotion. However, the potential benefit of screening patients should be selected based on the clinical situation, to avoid overtreatment.

关 键 词：新辅助放化疗 食管癌根治术 晚期食管癌 

分 类 号：R735.1[医药卫生—肿瘤]