食管鳞癌同期放化疗模式下高剂量与常规剂量放疗的疗效和安全性比较

Comparison of the Efficacy and Safety of High-dose and Conventional-dose Radiotherapy in the Mode of Concurrent Chemoradiotherapy for Esophageal Squamous Cell Carcinoma

目的探讨对食管鳞癌在同期放化疗模式治疗时采用高剂量放疗与常规剂量放疗的效果及安全性。方法选择2016年1月—2018年12月南通大学附属如皋医院收治的同期放化疗的食管鳞癌患者86例,按照随机数表法分为对照组(常规剂量放疗,n=43)与观察组(高剂量放疗,n=43),化疗两个周期后评价两组近期疗效,统计两组不良反应发生率,并进行持续随访,比较患者治疗12个月、18个月的局部控制率及生存率。结果观察组治疗总有效率(69.77%),与对照组(55.81%)比较,差异无统计学意义(χ^(2)=1.792,P>0.05)。观察组治疗12个月、18个月的局部控制率为86.05%、83.72%,生存率分别为90.70%、83.72%,高于对照组,差异有统计学意义(χ^(2)=5.103、6.824、4.914、6.824,P<0.05)。观察组不良反应发生率(23.26%)与对照组(27.91%)比较,差异无统计学意义(P>0.05)。结论食管鳞癌同期放化疗模式下高剂量与常规剂量放疗近期疗效相当,高剂量远期疗效更佳,安全可靠。

Objective To investigate the effect and safety of high-dose radiotherapy and conventional dose radiotherapy in the treatment of esophageal squamous cell carcinoma with concurrent chemoradiotherapy.Methods A total of 86 patients with esophageal squamous cell carcinoma who were treated with concurrent chemoradiotherapy in Rugao Hospital Affiliated to Nantong University from January 2016 to December 2018 were selected.According to the random number table method,they were divided into the control group(conventional dose radiotherapy,n=43)and the y observation group(high dose radiotherap,n=43).After two cycles of chemotherapy,the short-term efficacy of the two groups was evaluated,the incidence of adverse reactions in the two groups was counted,and continuous follow-up was conducted to compare the local control rate and survival rate of the patients after 12 months and 18 months of treatment.Results The total effective rate of the observation group was 69.77%,compared with 55.81%of the control group,the difference was not statistically significant(χ^(2)=1.792,P>0.05).The local control rates of the observation group were 86.05% and 83.72% for 12 months and 18 months of treatment,and the survival rates were 90.70% and 83.72%,respectively,which were higher than those of the control group,the difference was statistically significant(χ^(2)=5.103,6.824,4.914,6.824,P<0.05).Compared the incidence of adverse reactions(23.26%)in the observation group and(27.91%)in the control group,the difference was not statistically significant(P>0.05).Conclusion The short-term efficacy of high-dose and conventional-dose radiotherapy in the mode of concurrent chemoradiotherapy for esophageal squamous cell carcinoma is equivalent,and the long-term efficacy of high-dose is better,which is safe and reliable.