Ⅱb～Ⅲ期食管癌术后放疗与序贯放化疗的临床效果观察

Clinical observation of postoperative radiotherapy and sequential chemoradiotherapy for stage Ⅱb-Ⅲ esophageal cancer

目的探讨Ⅱb~Ⅲ期食管癌术后单纯放疗与序贯放化疗的临床效果。方法选择2014年10月~2016年6月本院收治的Ⅱb~Ⅲ期食管癌患者80例,按照随机数字表法分为两组,均为40例,对照组患者术后均行放射治疗,观察组行序贯化放疗,比较治疗两组肿瘤标志物等临床指标,统计两组临床治疗效果和治疗前后患者生活质量变化情况(包括两组患者的不良反应发生率、总生存率(OS)、无疾病生存率(DFS)、局部无复发生存率(LRFS)及无远处转移生存率(DMFS)。结果治疗后,观察组IgM、IgG、IgA水平均显著高于治疗前,差异有统计学意义(P<0.05),且高于治疗后对照组,差异有统计学意义(P<0.05),观察组有效率为52.5%,显著高于对照组的20.0%,差异有统计学意义(P<0.05),治疗后观察组生活质量评分显著优于治疗前及治疗后对照组,差异有统计学意义(P<0.05),两组不良反应比较差异无统计学意义(P>0.05),观察组1年总生存率、无疾病生存率、局部无复发生存率及无远处转移生存率均显著高于对照组,差异有统计学意义(P<0.05)。结论针对术后中晚期食管癌患者,同期放化疗或序贯化放疗能有效的改善局部症状,提高临床治疗效果,改善患者生活质量。

Objective To investigate the clinical effect of radiotherapy alone and sequential radiotherapy and chemotherapy for stage Ⅱ b-Ⅲ esophageal carcinoma. Methods Eighty patients with stage Ⅱ b-Ⅲ esophageal cancer treated in our hospital from October 2014 to June 2016 were selected and divided into two groups according to the random number method,all of which were 40 cases.The patients in the control group were treated with radiotherapy,and the observation group underwent sequential radiotherapy.The changes of tumor markers were compared between the two groups.The clinical efficacy and quality of life [including the incidence of adverse reactions,overall survival rate(OS),diseasefree survival rate(DFS),local recurrence-free survival rate(LRFS) and distant metastasis-free survival rate(DMFS)] of the two groups before and after the treatment were analyzed. Results After treatment,Ig M,Ig G,Ig A levels in the observation group were significantly higher than those before treatment,the difference was statistically significant(P < 0.05),and higher than those in the control group after treatment,the difference was statistically significant(P < 0.05).The effective rate of observation group was 52.5%,significantly higher than that of control group(20.0%),the difference was statistically significant(P < 0.05).The quality of life score of the observation group after treatment was significantly better than that of the control group before and after treatment(P < 0.05).There was no significant difference in adverse reactions between the two groups(P > 0.05).The overall 1-year survival rate,disease-free survival rate,local recurrence-free survival rate and distant metastasis-free survival rate in the observation group were significantly higher than those in the control group(P < 0.05). Conclusion For patients with middle and late postoperative esophagus cancer after operation,concurrent chemoradiotherapy or sequential radiotherapy can effectively improve the local symptoms,improve the effect of clinical treatment and improve the quality of life of the patients.