新辅助化疗联合腔镜手术治疗Ⅲ期食管鳞癌患者临床疗效

Clinical efficacy of neoadjuvant chemotherapy combined with endoscopic surgery in patients with stage Ⅲ esophageal squamous cell carcinoma

目的探讨新辅助化疗联合腔镜手术治疗Ⅲ期食管鳞癌患者的临床疗效。方法将158例Ⅲ期食管鳞癌患者按照化疗意愿分为研究组69例与对照组89例。研究组术前给予紫杉醇+奈达铂化疗2个周期,再给予腔镜手术治疗,对照组仅给予腔镜手术治疗。化疗结束后第3周评定研究组化疗效果,比较两组肿瘤切除情况、手术时间、术中出血量、并发症发生率。结果研究组化疗总有效率为69.6%,研究组R_(0)切除率显著高于对照组(P<0.01),术中出血量显著少于对照组(P<0.01),两组手术时间及并发症发生率比较差异无统计学意义(P>0.05)。结论新辅助化疗联合腔镜手术可以显著提高Ⅲ期食管鳞癌患者的R_(0)切除率,减少术中出血量,安全性高。

Objective To investigate the clinical efficacy of neoadjuvant chemotherapy combined with endoscopic surgery in patients with stage Ⅲ esophageal squamous cell carcinoma.Methods A total of 158 patients with stage Ⅲ esophageal squamous cell carcinoma were divided into study group(n=69)and control group(n=89)according to their willingness to chemotherapy.The study group was given paclitaxel+nedaplatin chemotherapy for 2 cycles before operation,and then given endoscopic surgery.The control group was only given endoscopic surgery.The chemotherapy effect of the study group was evaluated in the 3rd week after chemotherapy.The tumor resection,operation time,intraoperative bleeding and the incidence of complications were compared between the two groups.Results The total effective rate of chemotherapy in the study group was 69.6%.The R0 resection rate in the study group was significantly higher than that in the control group(P<0.01),and the amount of intraoperative bleeding was significantly less than that in the control group(P<0.01).There was no significant difference in operation time and complication rate between the two groups(P>0.05).Conclusions Neoadjuvant chemotherapy combined with endoscopic surgery can significantly improve the R0 resection rate of patients with stage Ⅲ esophageal squamous cell carcinoma,reduce the amount of intraoperative bleeding and have high safety.