新辅助放化疗序贯方案治疗Ⅲ期食管癌的疗效

Application of Neoadjuvant Chemotherapy in Sequential Treatment of Stage Ⅲ Esophageal Cancer

【目的】探讨新辅助放化疗在Ⅲ期食管癌序贯治疗中的应用价值。【方法】100例Ⅲ期食管癌患者按治疗方式分为单纯根治性化疗组（对照组，n=2），新辅助化疗序贯治疗组（观察组），对照组进行同步放疗，观察组完成2个周期化疗后开始放疗。比较两组肿瘤控制情况、治疗效果、安全性及患者生存质量。【结果】①观察近期总缓解率、随访1～3年肿瘤控制率、随访生存率与对照组相比差异均无显著性（P〉0．05）。②观察组Ⅰ～Ⅳ级胃肠道反应，Ⅰ～Ⅱ级放射性食管炎发生率均低于对照组（P〈0．05）。③治疗前两组生活质量评分比较差异无显著性（P〉005），治疗后不同时间两组生活质量评分均上升（P〈005），观察组随访1年、2年生活质量评分均高于对照组（P〈005）。【结论】对食管癌患者采用新辅助放化疗序贯治疗与同步放化疗治疗疗效相近，但新辅助放化疗序贯方案治疗安全性高，同时可提高患者远期生活质量。

[Objective]To investigate the application value of neoadjuvant chemotherapy in sequential treatment of stage Ⅲ esophageal cancer. [Methods]One hundred patients with stageⅢ esophageal cancer were divided into radical radiotherapy group （control group, n = 42） and the neoadjuvant sequential chemotherapy group （observation group） according to the treatment methods. The tumor control, treatment effect, safety and quality of life were compared between the two groups. [Results]The overall remission rate, tumor control rate followed up for 1-3 years, and follow-up survival rate of the observation group were not significantly dif- ferent compared with those of the control group （ P 〉0.05） ; Ⅰ - Ⅳ gastrointestinal reaction and the incidence of radiation esophagitis at Ⅰ - Ⅱ grade of the observation group were lower than those of the control group （ P 〈0.05） ; There was no significant difference in quality of life between the two groups before treatment （ P 〉 0.05）. The quality of life scores of the two groups were increased at different times （ P 〈0.05）, the quality of life scores of 1-2 yearfollowed-up were higher than those in the control group （ P 〈0.05）.[Conclusion]The efficacy of neoadjuvant chemotherapy sequential treatment and concurrent radiotherapy/chemotherapy is similar in the treatment of patients with esophageal cancer , but neoadjuvant sequential chemoradiotherapy regimen is safe and can improve the long-term quality of life.