术前同期放化疗并手术治疗局部晚期食管癌的前瞻性临床研究

A prospective study of preoperative concurrent chemoradiotherapy combined with surgery in the treatment of locally advanced esophageal carcinoma

目的评价局部晚期食管癌术前同期放化疗对提高患者生存率的价值。方法对术前临床分期为Ⅲ期,且无外科手术和放化疗禁忌证的69例食管癌患者进行术前放化疗的随机对照研究。综合治疗组29例,术前采用新辅助化疗(5氟尿嘧啶+顺铂)2个周期,同期行直线加速器放射治疗,剂量40 Gy;放化疗结束后3～5周手术。对照组40例,仅行单纯手术治疗。统计分析两组患者术后无瘤生存率及生存率。结果综合治疗组和对照组的5年无瘤生存率分别为28.9%vs.11.3%(P<0.05);5年生存率分别为35.1%vs.18.2%(P<0.05)。结论术前同期放化疗+手术治疗可明显提高Ⅲ期食管癌患者的生存率。

Objective This study was performed to assess the value in improving survival rate of preoperative concurrent ehemoradiotherapy for esophageal cancer. Methods 69 patients at m clinical stages and without contraindications for surgery and radiochemotherapy were selected in the study. 29 patients in combined therapy group were given 2 cycles of neoadjuvant chemotherapy （5-FU ＋ cisplatin） and the concurrent radiotherapy （linear accelerator machine produced radiation at the dosage of 40 Gy） , than tumors were resected at 3 - 5 weeks after concurrent chemotherapy and radiotherapy. 40 patients in the control group received surgery alone. SPSS 15.0 software was used to perform the disease free survival rate and survival rate. Results The five years disease free survival rate of combined therapy group and control group were 28.9% vs. 11.3% （P 〈 0.05 ）, the five years survival rate were 35.1% vs. 18.2% （ P 〈 0.05 ）. The postoperative survival rate of the combined therapy group was significantly higher than that of the control group. Conclusions Preoperative concurrent chemoradiotherapy markedly increased the survival rate for locally advanced esophageal carcinoma.