肿瘤坏死因子联合同步放化疗治疗中晚期食管癌的临床观察.docVIP

肿瘤坏死因子联合同步放化疗治疗中晚期食管癌的临床观察 　　【摘要】 目的：探讨肿瘤坏死因子联合同步放化疗治疗中晚期食管癌的临床疗效。方法：选取2013年2月-2014年12月本院收治的中晚期食管癌40例，随机分为试验组与观察组，每组各20例。试验组采用同步放化疗联合肿瘤坏死因子方案，对照组采用单纯同步放化疗方案，比较两种方案的治疗中晚期食管癌近期疗效及毒副反应。结果：试验组及对照组总有效率分别为95.0%、70.0%，比较差异有统计学意义（P0.05），但试验组中重度白细胞下降的发生率低于对照组，两组比较差异有统计学意义（P0.05）。结论：食管癌同步放化疗联合肿瘤坏死因子治疗食管癌疗效确切，毒副反应能耐受，需扩大病例数，进一步了解肿瘤坏死因子的疗效及安全性。 　　【关键词】 食管癌； 同步放化疗； 肿瘤坏死因子 　　【Abstract】 Objective：To discuss the clinical efficacy of tumor necrosis factor combined with concurrent radiotherapy and chemotherapy in the treatment of advanced esophageal cancer.Method：40 cases of advanced esophageal cancer treated in our hospital from February 2013 to December 2014 were selected and randomly divided into the experimental group and observation group， 20 cases in each group.The experimental group was treated with concurrent radiotherapy and chemotherapy combined with tumor necrosis factor， and the control group was treated with simple concurrent radiotherapy and chemotherapy.The short-term efficacy and toxicity of two groups were compared.Result：The total effective rate of the experimental group and the control group was respectively 95.0% and 70.0%，the difference between the two groups hd statistical significance（P0.05）.The control group showed significantly higher moderate-to-severe leucopenia than the trial group（P0.05）.Conclusion：Esophageal chemoradiation with tumor necrosis factor treatment of esophageal cancer curative effect is obvious，the adverse reaction tolerated，to expand the number of cases，further understand the effect of tumor necrosis factor and security. 　　【Key words】 Esophageal cancer； Concurrent chemoradiotherapy； Tumor necrosis factor 　　我国食管癌发病率和死亡率高居世界第一位，食管癌常规治疗以手术和放疗为主。对于不能手术的中晚期食管癌，单纯放射治疗疗效5年生存率长期徘徊在10%左右[1-2]。RTOG 85-01随机对照试验首次证明同步放化疗生存期明显优于单纯放疗，同步放化疗已成为不能手术食管癌患者的标准治疗方案[3-4]。如何选择安全有效的放疗增敏剂，以提高放疗疗效，是近年来肿瘤研究的热点之一[5]。选取本院2013年2月-2014年12月中晚期食管癌患者40例，其中20例采用放化疗同步TP（紫杉醇+奈达铂）联合肿瘤坏死因子（Tumor necrosis factor，TNF）方案，20例采用放疗同步TP（紫杉醇+奈达铂）方案，探讨放化疗前使用注射肿瘤坏死因子可以有效的放疗增敏，使肿瘤缩