新辅助化疗联合手术治疗食管癌的临床疗效及对患者预后的影响

Clinical effect of neoadjuvant chemotherapy combined with surgery in the treatment of esophageal cancer and its influence on prognosis of patients

目的探讨新辅助化疗联合手术治疗食管癌的临床疗效及对患者预后的影响。方法根据是否给予新辅助化疗将90例食管癌患者分为手术组和联合组,每组45例,手术组患者给予单纯根治手术治疗,联合组患者在根治手术前给予新辅助化疗。比较两组患者的临床疗效、术中及术后指标、不良反应发生情况及预后。结果联合组患者的总有效率明显高于手术组,差异有统计学意义(P<0.01)。联合组患者的术中出血量少于手术组,Ⅰ级切口愈合率高于手术组,吻合口瘘发生率低于手术组,差异均有统计学意义(P<0.05)。联合组患者骨髓抑制、消化道症状发生率均高于手术组(P<0.05)。联合组患者术后1、2、3年肿瘤复发率均低于手术组,术后2、3年生存率均高于手术组,差异均有统计学意义(P<0.05)。结论与单独手术治疗相比,新辅助化疗联合手术治疗食管癌患者可提高临床疗效,降低肿瘤复发率,提高术后生存率。

Objective To explore the clinical effect of neoadjuvant chemotherapy combined with surgery in the treatment of esophageal cancer and its influence on prognosis of patients.Method A total of 90 patients with esophageal cancer were divided into operation group(n=45,treated with surgery)and combination group(n=45,treated with neoadjuvant chemotherapy combined surgery).The clinical effect,intra-and post-operative indicators,adverse reactions and prognosis of the two groups were compared.Result The total effective rate of the combination group was higher than that of the operation group(P<0.01).The intraoperative blood loss was lower,I grade incision healing rate was higher and incidence of anastomotic stoma fistula was lower in combination group than those in operation group(P<0.05).The incidences of myelosuppression and gastrointestinal symptoms in the combination group were significantly higher than those in the operation group(P<0.05).The 1-,2-and 3-years tumor recurrence rate were lower,and 2-,3-years survival rate were higher in the combination group than those in the operation group(P<0.05).Conclusion Compared to surgical treatment alone,neoadjuvant chemotherapy combined surgery can improve the clinical effect,reduce the tumor recurrence rate and improve postoperative survival rate of patients with esophageal cancer.