三维适形放疗联合化疗对中、晚期食管癌患者近期疗效、毒副反应及远期预后生存的影响  

Effects of Three-dimensional Conformal Radiotherapy Combined with Chemotherapy on Short-term Curative Effect,Toxic and Side Reaction and Long-term Prognosis of Patients with Moderate or Advanced Esophageal Cancer

作　　者：张仑[1] 蔡金凤[1] 张华[1] ZHANG Lun;CAI Jin-feng;ZHANG Hua(The Second Department of Oncology Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院肿瘤中心二科,乌鲁木齐830054

出　　处：《解放军医药杂志》2021年第6期25-29,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：中华医学会临床医学科研专项资金-扬子江镇痛研究与发展项目(19010020771)。

摘　　要：目的分析三维适形放疗(3DCRT)联合化疗对中、晚期食管癌患者近期疗效、毒副反应及远期预后生存的影响。方法回顾性分析2018年5月—2019年5月本院收治的79例中晚期食管癌临床资料,按治疗方法不同分为放疗组34例和同步放化疗组45例。放疗组给予3DCRT,同步放化疗组给予3DCRT联合化疗。比较2组近期疗效、治疗前后生活质量和体力状况、毒副反应及治疗1、2、3年后生存情况。结果同步放化疗组临床总有效率高于放疗组(P<0.05)。与治疗前比较,2组治疗后生活质量和KPS评分均增高,且同步放化疗组高于放疗组,差异有统计学意义(P<0.05,P<0.01)。同步放化疗组白细胞减少、放射性食管炎Ⅱ、Ⅲ度毒副反应发生率高于放疗组(P<0.05)。同步放化疗组1、2、3年内生存率高于放疗组(P<0.05)。临床分期Ⅲ~Ⅳ期、同步化疗、有淋巴结转移、中高度分化程度是影响中晚期食管癌患者预后生存的独立危险因素(P<0.05,P<0.01)。结论3DCRT联合化疗对中、晚期食管癌具有良好的近期疗效,可提高远期生存率,改善预后,但毒副反应有所增加。Objective To analyze effects of three-dimensional conformal radiotherapy(3DCRT)combined with chemotherapy on short-term curative effect,toxic and side reaction and long-term prognosis of patients with moderate or advanced esophageal cancer.Methods Clinical data of 79 patients with moderate and advanced esophageal cancer admitted during May 2018 and May 2019 was retrospectively analyzed,and they were divided into radiotherapy group(only 3DCRT treatment,n=34)and concurrent radiotherapy and chemotherapy group(3DCRT combined with chemotherapy,n=45)according to different treatment methods.The short-term efficacy,quality of life and physical status before and after treatment,toxic and side reaction,and survival conditions after treatment for 1,2,and 3 years were compared between two groups.Results The total effective rate in concurrent chemoradiation group was significantly higher than that in radiotherapy alone group(P<0.05).After treatment,values of quality of life and Karnofsky performance status(KPS)score were significantly higher than those before treatment in two groups,and the values in concurrent chemoradiation group were significantly higher than those in radiotherapy group(P<0.05,P<0.01).Incidence rates of leukopenia and radiation esophagitis,and incidence rates ofⅡ°andⅢ°toxin and side effects in concurrent chemoradiation group were significantly higher than those in radiotherapy group(P<0.05).Survival rates within the 1 st,2 nd and 3 rd years in concurrent radiotherapy group were significantly higher than those in radiotherapy group(P<0.05).Clinical stageⅢ-Ⅳ,concurrent chemotherapy,having lymph node metastasis and moderate to high differentiation were independent risk factors affecting prognoses of patients with moderate or advanced esophageal cancer(P<0.05,P<0.01).Conclusion 3DCRT combined with chemotherapy has a good short-term effect in treatment of moderate or advanced esophageal cancer,and it may improve the long-term survival rate and prognoses,but the toxic and side effects have increased.

关 键 词：食管肿瘤 三维适形放疗 化放疗 药物毒性 存活率 危险因素 

分 类 号：R735.1[医药卫生—肿瘤]