同期放化疗联合深部热疗治疗胸段食管癌的临床观察

Clinical observation of concurrent radiochemotherapy combined with deep hyperthermia on thoracic esophageal carcinoma

目的:探讨同期放化疗联合深部热疗治疗胸段食管癌的近期疗效、远期疗效和不良反应。方法:90例胸段食管癌患者随机分为放化疗联合热疗组(联合组)、同期放化疗组(放化疗组)和单纯放疗组(放疗组),各30例,分别给予不同的治疗方法,观察和比较三组的近期疗效、远期疗效和不良反应。结果:联合组的临床有效率和临床获益率优于放化疗组和放疗组,差异有统计学意义(P<0.05)。联合组和放化疗组的总体生存率优于放疗组,而远处转移率低于放疗组(P<0.05)。联合组与同期放化疗组的骨髓抑制、放射性食管炎、恶性呕吐和肝肾功能损害的发生率均高于放疗组(P<0.05);但联合组与同期放化疗组比较,差异无统计学意义(P>0.05)。结论:同期放化疗联合深部热疗治疗胸段食管癌的近期疗效优于同步放化疗和单纯放疗,但在提高患者的生存率和降低放化疗的不良反应等方面无明显优势,具有一定的临床使用价值。

Objective：To investigate the effect of concurrent radiochemotherapy combined with deep hypertherimia on thoracic esophageal carcinoma. Methods：Ninety patients were randomly divided into radiochemotherapy combined with hypertherimia（ combination）group,concurrent radiochemotherapy（ radiochemotherapy）group and radiotherapy alone（ radiotherapy）group,30 cases in each group,received different treantments. The short-term,long-term effect and adverse reaction were compared between them. Results：The clinical efficiency and the clinical benefit rate of combination group were superior to them of radiochemotherapy group and radiotherapy group（p﹤0. 05）. The overall survival rates of combination group and radiochemotherapy group were better than that of radiotherapy group（ p﹤0. 05）. The incidence of myelosuppression,raidoactive esophagitis,nausea,vomiting and liver and renal function dam-age of combination group and radiochemotherapy group were higher than those of radiotherapy group（p﹤0. 05）. However,when the above indexes of combination group were compared with those of radiochemotherapy group,the difference had no statistical significance（p﹥0. 05）. Conclusion：Concurrent radiochemotherapy combined with deep hypertherimia on thoracic esophageal carcinoma has a better short-term clinical effect than concurrent radiochemo-therapy and radiotherapy alone,but has no obvious advantage on improving the survival rate and reducing the adverse reaction,which has certain clinical value.