文章摘要
刘玉辉 马楠 陈哓夏 徐龙 刘兆喆 谢晓冬.术后放化疗对淋巴结阳性食管鳞癌患者的临床意义[J].,2014,14(34):6704-6706
术后放化疗对淋巴结阳性食管鳞癌患者的临床意义
Clinical Significance of Postoperative Radiation and Chemotherapy inPatients with Esophageal Squamous Carcinoma Positive-Lymph Node
  
DOI:
中文关键词: 食管鳞癌  淋巴结阳性  术后放化疗
英文关键词: Esophageal squamous carcinoma  Positive lymph node  Postoperative chemoradiotherapy
基金项目:2012年辽宁省科技攻关计划课题(2012225019)
作者单位
刘玉辉 马楠 陈哓夏 徐龙 刘兆喆 谢晓冬 沈阳军区总医院肿瘤科 
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中文摘要:
      目的:探讨术后放化疗在治疗淋巴结阳性食管鳞癌中的毒副作用、临床预后及可能影响因素。方法:选择淋巴结阳性食管鳞 癌患者为研究对象,纳入研究患者共计64 例,术后放疗剂量为50 Gy,化疗方案为顺铂联合紫杉醇(21 d方案),观察并记录患者 不良反应情况,分析患者3 年无瘤生存情况,并进一步探讨可能影响预后的相关因素。结果:患者出现骨髓抑制(白细胞下降),其 中Ⅰ/Ⅱ度骨髓抑制39 例(61.0%),Ⅲ/Ⅳ度骨髓抑制19 例(29.7%);胃肠道反应Ⅰ/Ⅱ度15 例(23.4%),Ⅲ/Ⅳ度6 例(9.4%);无肝肾 功能异常或明显过敏反应;Ⅰ/Ⅱ度放射性食管炎和放射性气管炎分别为18 例(28.1%)和14 例(21.9%),晚期肺损伤Ⅲ/Ⅳ度2 例 (3.1%)。64 例患者的3 年无瘤生存期为28.8 个月,无瘤生存率为46.9%。本研究未发现明显影响术后放化疗治疗淋巴结阳性食管 鳞癌患者预后的相关因素(P>0.05)。结论:淋巴结阳性食管鳞癌患者术后放化疗的不良反应主要为白细胞下降、胃肠道反应和放 射性损伤等,患者均可耐受,且3 年无瘤生存显著改善,可用于淋巴结阳性食管鳞癌患者治疗。
英文摘要:
      Objective:To explore the side effects, clinical outcomes and possible influencing factors of postoperative chemoradiotherapy in treatment of lymph node positive esophageal squamous cell carcinomas.Methods:As research objects, the selected lymph node positive esophageal squamous carcinoma patients, in a total of 64 cases of patients, were given the postoperative radiotherapy dose of 50 Gy and chemotherapy regimens for cisplatin plus paclitaxel (21 d scheme), and to observe and record adverse reactions, 3 year disease-free survival in patients and further exploring the related factors affecting the prognosis.Results:Patients performed with bone marrow suppression (a decrease in white blood cells), including 39 cases (61.0%) of Ⅰ/Ⅱ and 19 cases (29.7%) of Ⅲ/Ⅳ degree of bone marrow inhibition; 15 cases (23.4%) of gastrointestinal reaction Ⅰ/Ⅱ degree, 6 cases (9.4%) of Ⅲ/Ⅳ degrees; without liver and kidney dysfunction or significant allergic reaction; 18 cases (28.1%) and 14 cases (21.9%) respectively of Ⅰ/Ⅱ degree of radioactive esophagitis and bronchitis, late lung injury Ⅲ /Ⅳ degree in 2 cases (3.1%). Disease-free lifetime of 3 years in 64 cases was 28.8 months, and disease-free survival rate was 46.9%. The present study found no significant postoperative chemoradiotherapy treatment factors in relative to the prognosis of patients with lymph node positive esophageal squamous carcinoma (P>0.05).Conclusion:Postoperative chemoradiotherapy. in lymph node positive esophageal squamous carcinoma patients had adverse reactions tolerated mainly for white blood cells decline, gastrointestinal reaction and radiation damage, and improved the 3-year disease-free survival of patients, can be used in treating patients with lymph node positive esophageal squamous carcinoma.
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