食管癌新辅助治疗的疗效评价及治疗后手术时机的选择-东南大学学报医学版

食管癌新辅助治疗的疗效评价及治疗后手术时机的选择

单位：1. 南京医科大学第一附属医院胸心外科, 江苏南京 210029;
2. 江苏省肿瘤医院胸外科, 江苏南京 210009

分类号：R735.1

出版年·卷·期（页码）：2015·34·第六期（967-970）

摘要：

目的:评价不同化疗周期食管癌新辅助治疗的疗效及探讨新辅助治疗后手术时机.方法:回顾性分析2012年9月至2014 年12月期间收治的40位局部晚期(Ⅲa~Ⅲc期)采取新辅助治疗后手术的食管鳞癌患者,按术前新辅助化疗周期将其分为两组,化疗2个周期为观察组,化疗3~4个周期为对照组,两组均有部分患者辅以同期放疗,化疗疗程结束后4周后手术;术前应用实体肿瘤疗效评价标准即RECIST标准评价两组有效率差异,并观察比较两组患者手术R0根治率、围手术期并发症发生率.结果:观察组有效率59.3%,对照组有效率69.2%,两组患者术前新辅助治疗有效率差异无统计学意义(P>0.05),两组患者均达到R0切除,在手术时间、术后出血、术后并发症发生率等方面两组差异亦无统计学意义(P>0.05),但术前化疗2周期患者治疗依从性更好,更容易接受手术及术后放化疗.结论:不同化疗周期食管癌新辅助治疗的疗效相当,化疗周期短的依从性更好,远期生存率有待进一步观察比较.

Objective: To evaluate the response of esophageal cancer to neoadjuvant therapy and the choice of operation time different chemotherapy cycle. Methods: The clinical data of 40 patients with local advanced esophageal cancer (Ⅲa-Ⅲc period), who underwent neoadjuvant therapy and post-treatment operation in our department from September 2012 to December 2014, were analyzed retrospectively. Patients treated with two cycles of chemotherapy were divided as observation group, and patients with 3-4 cycles were as control group. Some patients in both groups were treated with concurrent radiotherapy. Operations were performed four weeks after chemotherapy. Response Evaluation Criteria in Solid Tumors (RECIST) was used to evaluate the different effective rates between the two groups. R0 cure rate and perioperative complications were compared between the two groups. Results: Effective rate in observation group was 59.3%, which was not significantly different from that in control group (69.2%).All patients in both groups got R0 resection. There were no differences between the two groups in operation time, postoperative hemorrhage rate and incidence of postoperative complications (P>0.05). Patients in observation group preferred receiving surgery and postoperative radiotherapy and chemotherapy. Conclusions: The response to neoadjuvant therapy in esophageal cancer in different cycles of chemotherapy was equal, and patients with short cycles of chemotherapy got better compliance. Long-term survival still remains to be observed.

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