新辅助化疗联合微创手术治疗局部晚期食管癌疗效观察  

Clinical Analysis of Preoperative New Adjuvant Chemotherapy Plus Minimally Invasive Esophagectomy in Local Advanced Esophageal Carcinoma

作　　者：张文山[1] 沈国义[1] 

机构地区：[1]福建医科大学附属漳州市医院心胸外科,漳州363000

出　　处：《福建医科大学学报》2016年第4期252-255,共4页Journal of Fujian Medical University

摘　　要：目的探讨新辅助化疗联合微创手术在局部晚期食管癌的应用价值。方法收集120例临床分期Ⅲ期的食管癌患者,随机分为对照组和观察组各60例。观察组术前采用2周期的紫杉醇联合奈达铂方案化疗,化疗结束后3周手术;对照组直接行手术治疗。结果观察组化疗后完全缓解2例,部分缓解26例,稳定28例,进展4例,缓解率46.67%;缓解及稳定的56例行微创手术,4例进展患者未手术行同步放化疗。2组患者的手术并发症及手术时间比较,差别无统计学意义。观察组与对照组R0切除率分别为88.33%和73.33%,2组比较,差别有统计学意义(P<0.05)。结论新辅助化疗可降低食管癌肿瘤分期,提高根治性切除率,联合微创手术安全可行,远期生存率尚需进一步随访。Objective To evaluate the effect of endoscopic surgery following neoadjuvant chemotherapy for locally advanced esophageal cancer . Method 120 cases of clinical stage Ⅲ esophageal cancer were randomly divided into experimental group of 60 cases and 60 cases of control group in our center . The patients in the experimental group underwent 2 cycles of chemotherapy with combination of paclitaxel and nedaplatin followed by surgery . Surgery was performed three weeks after chemotherapy . The patients in the control group underwent surgery alone . Results 2 cases in the experimental group showed complete response ,26 cases partial response ,28 cases stable disease and 4 cases showed progressive disease . The response rate was 46 .67% . Four patients undergoing surgery who showed progress underwent concurrent chemoradiotherapy . There was no significant difference in postoperative complications and surgical time between the two groups . The R0 resection rate was 88 .33% vs 73 .33% ,and the difference was statistically significant （P〈 0 .05） . Conclusion Neoadjuvant chemotherapy can reduce esophageal cancer staging ,increase radical resection rate ,and when combined with minimally invasive esophagectomy the treatment is safe and feasible . However ,the further follow-up is needed for a long-term survival analysis .

关 键 词：食管肿瘤 化学疗法 辅助 外科手术 微创性 治疗结果 

分 类 号：R735.1[医药卫生—肿瘤]