新辅助放化疗联合免疫治疗对可切除食管鳞癌疗效的临床研究  

Clinical Study of Neoadjuvant Chemoradiotherapy Combined with Immu⁃notherapy for Resectable Esophageal Squamous Cell Carcinoma

作　　者：吴成焱 陈刚 李劲 吴幸谕 程典文 陈厚赏 林凯旋 WU Chengyan;CHEN Gang;LI Jin;WU Xingyu;CHENG Dianwen;CHEN Houshang;LIN Kaixuan(Oncology DepartmentⅡ,Yangjiang People′s Hospital,Yangjiang 529500,Guangdong,China;Department of Thoracic Surgery,Yangjiang People′s Hospital,Yangjiang 529500,Guangdong,China)

机构地区：[1]阳江市人民医院肿瘤二科,广东阳江529500 [2]阳江市人民医院胸外科,广东阳江529500

出　　处：《系统医学》2024年第13期75-78,共4页Systems Medicine

基　　金：阳江市医疗卫生类科技计划项目-SF2022030。

摘　　要：目的分析新辅助放化疗联合免疫治疗在可切除食管鳞癌患者中的应用效果。方法非随机选取阳江市人民医院于2022年8月—2023年12月期间收治的20例可手术的胸段食管鳞癌患者为研究对象,均采用新辅助放化疗联合免疫治疗,对患者治疗后的疗效及安全性进行分析。结果经过新辅助放化疗,术前疗效评价为完全缓解有2例(10.00%),部分缓解有17例(85.00%),疾病稳定有1例(5.00%),疾病进展为0,客观缓解率为95.00%;所有患者均成功行根治性手术。手术均达R0切除,术后R0切除率100.00%。肿瘤残留细胞0有9例(45.00%),0~<11%有7例(35.00%),11%~<51%有2例(10.00%),51%~90%有2例(10.00%),病理完全缓解率为45.00%;在治疗后,Ⅲ~Ⅳ粒细胞减少症患者2例(10.00%),严重消化道反应患者3例(15.00%),食管穿孔患者为0,皮炎患者4例(20.00%)。结论新辅助放化疗联合免疫治疗能够缩小患者肿瘤体积,具有较高的病理完全缓解率,能提高根治手术的成功率,且不良反应相对较轻,在可切除食管鳞癌患者中具有良好的应用效果。Objective To analyze the effect of neoadjuvant chemoradiotherapy combined with immunotherapy in pa-tients with resectable esophageal squamous cell carcinoma.Methods Twenty patients with operable thoracic esopha-geal squamous cell carcinoma admitted to Yangjiang People's Hospital from August 2022 to December 2023 were un-randomly selected as the study objects.All of them were treated with neoadjuvant chemoradiotherapy combined with immunotherapy,and the therapeutic efficacy and safety of the patients were analyzed.Results After neoadjuvant radio-therapy and chemotherapy,the preoperative efficacy was evaluated as complete remission in 2 cases(10.00%),partial remission in 17 cases(85.00%),stable disease in 1 case(5.00%),progressive disease in 0,and the objective remission rate was 95.00%.All patients underwent radical surgery successfully.The R0 resection rate was 100.00%.There were 9 cases of 0(45.00%),7 cases of 0~<11%(35.00%),2 cases of 11%~<51%(10.00%),and 2 cases of 51%~90%(10.00%)of residual tumor cells.The pathological complete response rate was 45.00%.After treatment,there were 2 patients withⅢ-Ⅳgranulocytopenia(10.00%),3 patients with severe digestive tract reaction(15.00%),0 with esophageal perforation and 4 patients with dermatitis(20.00%).Conclusion Neoadjuvant chemoradiotherapy com-bined with immunotherapy can reduce the tumor volume of patients,has a high pathological complete remission rate,can improve the success rate of radical surgery,and the adverse reaction is relatively mild,and has a good application effect in patients with resectable esophageal squamous cell carcinoma.

关 键 词：食管鳞癌 化学疗法 放射疗法 免疫治疗 切除率 

分 类 号：R735.1[医药卫生—肿瘤]