局部晚期食管癌术前放化疗的临床应用

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1、局部晚期食管癌术前放化疗的临床应用饶新辉王晓阳(广东省梅州市人民医院胸外科514089)【摘要】目的探研局部晚期食管癌术前放化疗的临床疗效。方法木院在2008年4月〜2012年8月收治食管癌患者228例，随机分成两组，观察组118例釆用术前放化疗再施行外科手术治疗，对照组110例直接施行外科手术。结果观察组107例患者肿瘤明显缩小，根治性切除101例，根治性切除率为85.6%;对照组根治性切除76例，根治性切除率为69.1%，观察组患者的根治性切除率高于对照组，两组比较差异具有统计学意义(P<0.0

2、5)o观察组姑息性切除率为9.3%,剖胸探查率8.5%;对照组姑息性切除率为14.6%,剖胸探查率18.2%,观察组的姑息性切除率、剖胸探查率低于对照组，两组比较差异只有统计学意义(P<0.05＞。观察组患者术后3年生存率为63.6%,5年生存率为42.4%;对照组患者术后3年生存率35.5%，5年生存率为20.9%,观察组的3年生存率、5年生存率显著高于对照组，两组比较差异具有统计学意义(P<0.05)o结论术前放化疗可降低食管癌肿瘤分期，提高根治性切除率，不增加围术期并发症发生率，并＞1.

3、可提高患者术后生存率，值得临床推广应用。【关键词】食管癌术前放化疗局部晚期【中图分类号】R459.5【文献标识码】A【文章编号】2095-1752(2014)06-0098-02[Abstract]Target:Researchonclinicaleffectsonlocallyadvancedesophagealcancerofpreoperativechemoradiotherapy.Methods:ourhospitalhascured228patientswithesophagealcancer,

4、randomlydividedintotwogroups.118patientsinobservationgroupwereperformedsurgeryafterpreoperativechemoradiotherapy,while110patientsincontrolgroupwereperformedsurgerydirectly.Results:107patientsinobservationgrouphaveanobviousreductionintumors.Theradicalresec

5、tionrateoftheobservationgroupreaches85.6%whileofthecontrolgroupis69.1%,whichshowsahigherrateintheobservationgroups.Thecomparativedifferencesofthetwogroupsisofstatisticalsignificance(P<0.05).Palliativeresectionrateinobservationgroupis9.3%,thoracotomydet

6、ectionrateis8.5%whilepalliativeresectionrateincontrolgroupis14.6%,thoracotomydetectionrateis20.9%.Bothpalliativeresectionrateandthoracotomydetectionrateinobservationgroupislowerthanincontrolgroup.Thecomparativedifferencesofthetwogroupsisofstatisticalsigni

7、ficance(P<0.05).The3yearssurvivalrateofthepatientsinobservationgroupafteroperationis63.6%,and5yearsyearssurvivalrateis42.4%.Whilethe3yearssurvivalrateofthepatientsincontrolgroupafteroperationis35.5%and5yearsyearssurvivalrateis20.9%.Obviously,thesurviva

8、lrateof3yearsand5yearsafteroperationarebothhigherinobservationgroup.Thecomparativedifferencesofthetwogroupsisofstatisticalsignificance(P<0.05).Conclusions:Preoperativechemoradiotherapycanreduceesophagealcancersta