局部晚期食管癌术前放化疗的临床应用.docVIP

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 本院在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例采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（Plt;0.05)。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，两组比较差异具有统计学意义（Plt;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（Plt;0.05)。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，并且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: Research on clinical effects on locally advanced esophageal cancer of preoperative chemoradiotherapy. Methods: our hospital has cured 228 patients with esophageal cancer, randomly divided into two groups. 118 patients in observation group were performed surgery after preoperative chemoradiotherapy, while 110 patients in control group were performed surgery directly. Results: 107 patients in observation group have an obvious reduction in tumors. The radical resection rate of the observation group reaches 85.6% while of the control group is 69.1%, which shows a higher rate in the observation groups. The comparative differences of the two groups is of statistical significance（Plt;0.05).Palliative resection rate in observation group is 9.3%, thoracotomy detection rate is 8.5% while palliative resection rate in control group is 14.6%, thoracotomy detection rate is 20.9%. Both palliative resection rate and thoracotomy detection rate in observation group is lower than in control group. The comparative differences of the two groups is of statistical significance（Plt;0.05). The 3 years survival rate of the patients in observation group after operation is 63.6%, and 5 years years survival rate is 42.4%. While the 3 years survival rate of the patients in control group after operation