术前放化疗与单纯手术治疗可切除食管癌临床分析

The efficacy and safety of preoperative radiotherapy and chemotherapy alone for resectable esophageal cancer patients

目的对比可切除食管癌患者术前放化疗与单纯手术两种治疗方式的有效性及安全性。方法选择2015年1月至2016年1月医院收治的可切除食管癌患者98例,采用随机多中心前瞻性临床研究,将患者分为两组,每组各49例。其中对照组给予单纯手术治疗,研究组在手术治疗前给予放化疗。对比两组治疗效果,并发症的发生情况及生存率。结果对照组、研究组有效率分别为55.10%、89.80%,研究组有效率显著高于对照组,两组差异有统计学意义(P<0.05);本研究中49例患者均完成放化疗,无Ⅳ级毒副反应,Ⅲ级毒副反应主要为白细胞减少、恶心呕吐;两组RO切除率、淋巴结清扫站数、淋巴结清扫个数、并发症的发生率相比差异有统计学意义(P<0.05);随访3年,研究组复发、转移明显少于对照组,研究组生存期明显较对照组延长,两组差异有统计学意义(P<0.05)。结论术前放化疗治疗可切除食管癌临床效果优于单纯手术,患者生存期延长,且安全性高。

Objective To compare the efficacy and safety of preoperative chemoradiotherapy and surgery alone in patients with resectable esophageal cancer.Methods Ninety-eight patients with resectable esophageal cancer admitted to the hospital from January 2015 to January 2016 were enrolled.A randomized,multi-center prospective clinical study was performed.The patients were divided into two groups,49 in each group.The patients in the control group were given only surgical treatment,the patients in the study group weregiven radiotherapy and chemotherapy before surgery.The treatment effects of the two groups were compared,including the incidence of complication and survival rate.Results The effective rate of the control group and the study group were 55.10%and 89.80%respectively.The effective rate of the study group was significantly higher than that of the control group.The difference between the two groups was statistically significant(P<0.05).In thestudy group,49 patients completed the radiotherapy and chemotherapy before surgery.There was no gradeⅣtoxic side reaction,and the gradeⅢtoxic side effects were mainly leukopenia and nausea and vomiting.The differencesof RO resection rate,lymph node dissection,lymph node dissection,and complication rate between the two groups were statistically significant(P<0.05).After 3 years follow-up,the recurrence and metastasis of the study group were significantly less than that of the control group.The survival time of the study group was significantly longer than that of the control group.The differences were statistically significant(P<0.05).Conclusion The clinical effect of preoperative chemoradiotherapy for resectable esophageal cancer is better than that of simple surgery.The survival time of patients is prolonged and the safety is high.