90例不同部位食管癌同步放化疗后疗效分析  

Concurrent chemoradiotherapy for 90 patients in different parts of esophageal carcinoma

作　　者：陈丽[1] 汪步海[1] 戴尔珣[1] 葛宜枝[1] 蒋亚齐[1] 

机构地区：[1]江苏省苏北人民医院肿瘤科,扬州225001

出　　处：《国际肿瘤学杂志》2016年第3期177-179,共3页Journal of International Oncology

摘　　要：目的 探讨颈胸上段食管癌和胸中下段食管癌同步放化疗疗效及食管狭窄情况.方法 选取2011年1月至2014年12月在江苏省苏北人民医院诊治的不同部位食管癌初治患者90例,均行同步放化疗,放疗中位剂量60 Gy,化疗方案为紫杉醇联合奈达铂方案.其中,颈胸上段食管癌48例,胸中下段食管癌42例,比较两组近期有效率、局部控制率、生存率及食管狭窄情况.结果 随访率为100％,颈胸上段食管癌组和胸中下段食管癌组近期有效率分别为81.2％、73.8％（x2=0.717,P=0.397）;1年局部控制率分别为90.3％、71.8％（x2=5.865,P=0.015）;1年生存率分别为87.5％、69.0％（x2=4.580,P=0.032）;中度及以上程度食管狭窄发生率分别为55.6％、29.4％（x2 =5.360,P=0.021）.两组在近期疗效方面差异无统计学意义,而颈胸上段食管癌组在1年局部控制率、1年生存率和食管狭窄发生率上均明显高于胸中下段食管癌组,差异有统计学意义.结论 颈胸上段食管癌疗效较胸中下段食管癌好,但颈胸上段食管癌放疗后食管狭窄程度较胸中下段食管癌重.Objective To explore the effectiveness and esophageal strictures of concurrent chemoradiotherapy in patients with cervical and upper-thoracic esophageal cancer （EC） and middle-thoracic and lower-thoracic EC.Methods Between January 2011 and December 2014,ninety patients with different parts of EC were treated with radiotherapy combined with concurrent chemotherapy in People＇s Hospital of Subei.The median irradiation dose was 60 Gy.The chemotherapy regimens consisted of Paclitaxel and Nedaplatin.Of all the patients,48 patients had cervical and upper-thoracic EC,42 patients had middle-thoracic and lowerthoracic EC.The response rates,the local control rates,the survival rates and esophageal strictures were evaluated between two groups.Results The follow-up rate was 100％.The response rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 81.2％ and 73.8％ （x2 =0.717,P =0.397）,respectively.The 1-year local control rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 90.3％ and 71.8％ （x2 =5.865,P =0.015）,respectively.The 1-year survival rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 87.5％ and 69.0％ （x2 =4.580,P =0.032）,respectively.The moderate-to-severe esophageal strictures rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 55.6％ and 29.4％ （x2 =5.360,P =0.021）,respectively.There were no significant differences in shortterm effects between the cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC.The patients with cervical and upper-thoracic EC showed significantly higher 1-year local control rates,1-year survival rates and esophageal strictures rates than those with middle-thoracic and lower-thoracic EC.Conclusion The effectiveness of concurrent chemoradiotherapy is better in the patients with cervical and upper-thoracic EC than in those with middle-tho

关 键 词：食管肿瘤 预后 放射疗法 药物疗法 

分 类 号：R735.1[医药卫生—肿瘤]