术前新辅助放化疗在食管癌胸腹腔镜手术患者中的应用价值  

Value of Preoperative Neoadjuvant Chemoradiotherapy in Patients Undergoing Thoracoscopic and Laparoscopic Surgery for Esophageal Cancer

作　　者：崔杰[1] 韩文杰[1] 王瑜[1] CUI Jie;HAN Wenjie;WANG Yu(Shangqiu First People's Hospital,Shangqiu,476000)

机构地区：[1]河南省商丘市第一人民医院,476000

出　　处：《实用癌症杂志》2023年第4期630-633,共4页The Practical Journal of Cancer

摘　　要：目的 研究术前紫杉醇联合顺铂新辅助放化疗对食管癌胸腹腔镜手术患者肿瘤组织细胞活性及预后的影响。方法 选取106例食管癌患者,按治疗方案不同分成对照组50例、研究组56例。2组均接受胸腹腔镜手术治疗,其中对照组术前未行任何治疗,研究组术前行新辅助放化疗治疗。术后随访6个月,对比2组近期临床疗效,并观察2组手术前后肿瘤组织细胞活性[细胞增殖指数(PI)及DNA指数(DI)、S期细胞百分率(SPF)]、生活质量[肿瘤病人的生活质量评分(QOL)]变化及预后效果。结果 研究组治疗总缓解率[48.21%(27/56)]高于对照组[28.00%(14/50)],差异有统计学意义(P<0.05)。对照组治疗前后肿瘤组织细胞PI、DI、SPR值对比,差异无统计学意义(P>0.05);相比于治疗前,研究组治疗后7 d肿瘤组织细胞PI、DI、SPR值均降低,且低于对照组,差异有统计学意义(P<0.05)。相比于治疗前,2组治疗后3个月的QOL评分均增高,且研究组高于对照组,差异有统计学意义(P<0.05)。研究组治疗后6个月内局部复发率、远处转移率[19.64%(11/56)、12.50%(7/56)]均低于对照组[40.00%(20/50)、28.00%(14/50)],生存率[83.93%(47/56)]高于对照组[66.00%(33/50)],差异有统计学意义(P<0.05)。结论 术前紫杉醇联合顺铂新辅助放化疗能进一步提高食管癌胸腹腔镜手术治疗效果,降低肿瘤组织细胞活性,改善患者生活质量与预后,可于临床推广。Objective To study the effect of preoperative paclitaxel combined with cisplatin neoadjuvant radiotherapy and chemotherapy on the cell activity and prognosis of tumor tissue in patients undergoing thoracoscopic and laparoscopic surgery for esophageal cancer.Methods 106 patients with esophageal cancer were selected and divided into the control group(50 cases)and the study group(56 cases)according to different treatment schemes.Both groups received thoracoscopic and laparoscopic surgery,of which the control group did not receive any treatment before surgery,and the research group received neoadjuvant radiotherapy and chemotherapy before surgery.The 2 groups were followed up for 6 months,and the recent clinical effects were compared.The changes of tumor tissue cell activity[cell proliferation index(PI),DNA index(DI),S-phase cell percentage(SPF)],quality of life[quality of life score(QOL)]and prognosis were observed before and after surgery.Results The total remission rate in the study group[48.21%(27/56)]was higher than that in the control group[28.00%(14/50)],and the difference was statistically significant(P<0.05);The PI,Di and SPR values of tumor tissue cells in the control group before and after treatment were not significantly different(P>0.05);Compared with before treatment,the PI,Di and SPR values of tumor tissues and cells in the study group were all decreased on the 7th day after treatment,and were lower than those in the control group(P<0.05);Compared with before treatment,QOL scores of the 2 groups increased 3 months after treatment,and the difference between the study group and the control group was statistically significant(P<0.05);The local recurrence rate and distant metastasis rate[19.64%(11/56),12.50%(7/56)]in the study group within 6 months after treatment were lower than those in the control group[40.00%(20/50),28.00%(14/50)],and the survival rate[83.93%(47/56)]was higher than that in the control group[66.00%(33/50)],with statistical significance(P<0.05).Conclusion Preoperative paclitaxel combined

关 键 词：食管癌 新辅助放化疗 胸腹腔镜手术 肿瘤组织细胞活性 预后效果 

分 类 号：R735.1[医药卫生—肿瘤]