内镜下病灶切除联合局部化疗及放疗治疗食管癌有效性观察

The effectiveness of endoscopic resection of the lesion combined with local chemotherapy and radiotherapy for esophageal carcinoma

目的探讨内镜下病灶切除联合局部化疗及放疗治疗食管癌的有效性,为临床治疗提供参考。方法选取2011年2月至2012年2月来我院治疗的中晚期隆起型食管癌食道癌患者70例,根据患者的病情程度并在患者知情前提下分为对照组和观察组,每组各35例。在确诊的基础上为对照组患者采用单独放射治疗,为观察组患者采取内镜下病灶切除、植入化疗缓释粒子化疗及放疗治疗,对比两组患者的治疗效果,手术后不良反应率及治疗1年、2年后存活率。结果在不同的治疗方法下,两组患者的治疗效果出现了一定的差异。在治疗总有效率上,观察组以明显高于对照组,对比差异性显著有统计学意义(P<0.05);在术后不良反应发生率上,观察组和对照组没有明显区别,对比差异性不显著无统计学意义(P>0.05);在1年、2年后,观察组的存活率明显高于对照组,对比差异性显著有统计学意义(P<0.05)。结论研究表明,内镜下病灶切除联合局部化疗及放疗治疗中晚期食管癌较单纯放射治疗效果好,安全性较高,能延长患者的存活时间,有很强的临床推广意义。

Objective： To explore the effectiveness of endoscopic resection of the lesion combined with local chemotherapy and radiotherapy in the treatment of esophageal cancer,and to provide reference for clinical treatment. Method： 70 cases of esophageal carcinoma patients,with advanced esophageal carcinoma,treated by our hospital were selected from February 2011 to February 2012. According to the severity of the disease and In the premise of informed,patients was divided into two groups,the control group and the observation group,35 cases in each set. On the basis of the diagnosis,the control department was treated with radiotherapy alone,But in the observation group,the sick person were treated by endoscopic resection of the tumor,the implantation of chemotherapy and the release of the chemotherapy and radiotherapy. And then make the comparison of effectiveness of treatment between two sets,including the rate of adverse events after surgery,in the first and second years. Result： Under different treatment methods,the treatment effect of the two groups of patients had a certain difference. The total efficiency of treatment,in observation group was significantly higher than the control group,the differences was statistically significant（ P 〈0. 05）. In the postoperative incidence of adverse reactions,the observation group and the control group made no significant difference. There was no significant difference between the two group in the incidence of adverse reactions after operation（ P 〉0. 05）. In 1 years,2 years later,the survival rate of observation set was significantly higher than the control one,the differences were statistically significant（ P 〈0. 05）. Conclusion： Research had shown that,endoscopic resection combined with local chemotherapy and radiotherapy compared with radiotherapy alone in the treatment of advanced esophageal cancer with good effect,high security,prolonging survival time in patients. So it had very strong clinical significance.