局部进展期食管鳞癌新辅助放化疗与新辅助化疗比较

doi:10.3760/cma.j.issn.1004-4221.2017.03.006

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摘要

目的比较局部进展期食管鳞癌NCRT与NCT疗效。方法收集2009—2015年在本院分别接受NCRT与NCT联合手术治疗的177例食管鳞癌患者资料,其中NCRT组72例,NCT组105例。采用Kaplan-Meier法生存分析。结果两组总样本量177例(临床分期cT_2-4N_0-1M₀期),2、3年样本量NCRT组分别为44、26例,NCT组分别为47、28例。NCRT组pCR率为22%,明显高于NCT组10%(P=0.019)。两组术后并发症发生率和死亡率、复发率均相近(P均>0.05)。NCRT组与NCT组2、3年OS率分别为74%、51%与64%、51%,DFS率分别为54%、50%与54%、46%(P=0.527、0.379)。结论 NCRT较NCT可明显提高局部进展期食管鳞癌患者pCR率,同时并未增加术后并发症发生率和死亡率,但两组患者生存无差异,最终结果仍需前瞻性、多中心、大样本研究证实。

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	李雪
	郝大选
	杨原源
	程欣宇
	吴小源
	陈永顺
	蒋琼
	贺春语
	刘劲松
	刘文娟
	王建华

关键词 ：食管肿瘤/化学疗法, 食管肿瘤/放化疗法, 新辅助放化疗法, 预后

Abstract：

Objective To compare the efficacy of neoadjuvant chemoradiotherapy (NCRT) and neoadjuvant chemotherapy (NCT) in treating locally advanced esophageal squamous cell carcinoma. Methods We retrospectively analyzed a total of 177 patients who received NCRT (72 patients) or NCT (105 patients) combined with surgery for esophageal squamous cell carcinoma from January 2009 to October 2015 in the Affiliated Cancer Hospital of Zhengzhou University. The survival rate was analyzed using the Kaplan-Meier method. Results Among the 177 patients (clinical stage cT_2-4N_0-1M₀), the 2-and 3-year sample sizes were 44 and 26 in the NCRT group, and 47 and 28 in the NCT group. The pathological complete response (pCR) rate was significantly higher in the NCRT group than in the NCT group (22% vs. 10%, P=0.019). There were no significant differences in the incidence of postoperative complications, mortality, and recurrence rate between the two groups (all P>0.05). The 2-and 3-year overall survival rates for the NCRT group were 74% and 51%, versus 64% and 51% for the NCT group (P=0.527);the 2-and 3-year disease-free survival rates for the NCRT group were 54% and 50%, versus 54% and 46% for the NCT group (P=0.379). Conclusions Compared with NCT, NCRT significantly increases the pCR rate without increasing postoperative complications and mortality in esophageal squamous cell carcinoma patients. However, since the survival rate is similar between the two groups, the efficacy of NCRT and NCT remains to be verified by further prospective, multi-centered, and large-sample studies.

Key words： Esophageal neoplasms/chemotherapy Esophageal neoplasms/chemoraidotherapy Adjuvant chemoradiotherapy Prognosis

收稿日期: 2016-08-24

通讯作者: 王建华,Email:huajianye@sina.com

引用本文:

李雪,郝大选,杨原源等. 局部进展期食管鳞癌新辅助放化疗与新辅助化疗比较[J]. 中华放射肿瘤学杂志, 2017, 26(3): 274-278.

Li Xue,Hao Daxuan,Yang Yuanyuan et al. Comparison of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy in treating locally advanced esophageal squamous cell carcinoma　[J]. Chinese Journal of Radiation Oncology, 2017, 26(3): 274-278.

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