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1、局部晚期食管癌術(shù)前放化療的臨床應(yīng)用饒新輝王曉陽(廣東省梅州市人民醫(yī)院胸外科514089)【摘要】目的探研局部晚期食管癌術(shù)前放化療的臨床療效。方法木院在2008年4月?2012年8月收治食管癌患者228例，隨機(jī)分成兩組，觀察組118例釆用術(shù)前放化療再施行外科手術(shù)治療，對(duì)照組110例直接施行外科手術(shù)。結(jié)果觀察組107例患者腫瘤明顯縮小，根治性切除101例，根治性切除率為85.6%;對(duì)照組根治性切除76例，根治性切除率為69.1%，觀察組患者的根治性切除率高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.0
2、5)o觀察組姑息性切除率為9.3%,剖胸探查率8.5%;對(duì)照組姑息性切除率為14.6%,剖胸探查率18.2%,觀察組的姑息性切除率、剖胸探查率低于對(duì)照組，兩組比較差異只有統(tǒng)計(jì)學(xué)意義(P<0.05＞。觀察組患者術(shù)后3年生存率為63.6%,5年生存率為42.4%;對(duì)照組患者術(shù)后3年生存率35.5%，5年生存率為20.9%,觀察組的3年生存率、5年生存率顯著高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)o結(jié)論術(shù)前放化療可降低食管癌腫瘤分期，提高根治性切除率，不增加圍術(shù)期并發(fā)癥發(fā)生率，并＞1.
3、可提高患者術(shù)后生存率，值得臨床推廣應(yīng)用?！娟P(guān)鍵詞】食管癌術(shù)前放化療局部晚期【中圖分類號(hào)】R459.5【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】2095-1752(2014)06-0098-02[Abstract]Target:Researchonclinicaleffectsonlocallyadvancedesophagealcancerofpreoperativechemoradiotherapy.Methods:ourhospitalhascured228patientswithesophagealcancer,
4、randomlydividedintotwogroups.118patientsinobservationgroupwereperformedsurgeryafterpreoperativechemoradiotherapy,while110patientsincontrolgroupwereperformedsurgerydirectly.Results:107patientsinobservationgrouphaveanobviousreductionintumors.Theradicalresec
5、tionrateoftheobservationgroupreaches85.6%whileofthecontrolgroupis69.1%,whichshowsahigherrateintheobservationgroups.Thecomparativedifferencesofthetwogroupsisofstatisticalsignificance(P<0.05).Palliativeresectionrateinobservationgroupis9.3%,thoracotomydet
6、ectionrateis8.5%whilepalliativeresectionrateincontrolgroupis14.6%,thoracotomydetectionrateis20.9%.Bothpalliativeresectionrateandthoracotomydetectionrateinobservationgroupislowerthanincontrolgroup.Thecomparativedifferencesofthetwogroupsisofstatisticalsigni
7、ficance(P<0.05).The3yearssurvivalrateofthepatientsinobservationgroupafteroperationis63.6%,and5yearsyearssurvivalrateis42.4%.Whilethe3yearssurvivalrateofthepatientsincontrolgroupafteroperationis35.5%and5yearsyearssurvivalrateis20.9%.Obviously,thesurviva
8、lrateof3yearsand5yearsafteroperationarebothhigherinobservationgroup.Thecomparativedifferencesofthetwogroupsisofstatisticalsignificance(P<0.05).Conclusions:Preoperativechemoradiotherapycanreduceesophagealcancersta
