三维适形放疗不同联合方式治疗中晚期食管癌的对比研究-东南大学学报医学版

三维适形放疗不同联合方式治疗中晚期食管癌的对比研究

单位：1. 河北省承德市第三医院肿瘤科, 河北承德 067000;
2. 河北省承德市妇幼保健院, 河北承德 067000;
3. 河北省平泉县党坝中心卫生院, 河北平泉 067500;
4. 河北省承德市双滦区医院, 河北承德 067000;
5. 北京市通州区263医院, 北京 100000

关键词：三维适形奈达铂热疗化疗食管癌

分类号：R735.1

出版年·卷·期（页码）：2014·33·第一期（40-44）

摘要：

目的：观察三维适形放疗不同联合方式治疗中晚期食管癌的临床疗效、生存率、毒副反应。方法：将90例经病理证实的未治疗的中晚期食管癌患者随机分成单纯放疗组、放化疗组、放化热疗组3组各30例，分别采用相应的联合方式治疗，治疗结束后3个月评估近期疗效和毒副反应，随访结束后评估远期疗效。结果：治疗总有效率单纯放疗组为46.7%，放化疗组为63.3%，放化热疗组为86.7%，3组比较差异有统计学意义（P<0.05）。3组1年生存率依次为50%、66.7%、86.7%，3组比较差异有统计学意义（P<0.05）。单纯放疗组放射性食管炎、放射性肺炎、骨髓抑制发生率明显低于放化疗组及放化热疗组，差异有统计学意义（P<0.05）。结论：放化疗联合体外高频热疗治疗中晚期食管癌，有效率和生存率进一步提高，毒副反应可耐受。

Objective: To observe the clinical curative effect, survival rate and adverse reaction of advanced esophageal carcinoma, we applied different combinations of the three-dimensional conformal radiotherapy. Methods: 90 cases of advanced esophageal carcinoma confirmed by pathology were divided randomly into radiotherapy group(n=30),chemoradiotherapy group(n=30), hyperthermochemoradiotherapy group(n=30).After three months of treatment, the near future curative effect and adverse reaction were evaluated;the long-term curative effect was determined at the end of follow-up. Results: Radiotherapy group had an effective rate of 46.7%. Chemoradiotherapy group 63.3%, Hyperthermochemoradiotherapy group 86.7%, the differences among the three groups were statistically significant(P<0.05).One year survival rate in each group were 50%, 66.7%,86.7%,with statistical significance(P<0.05). The incidence of radiation esophagitis, radiation pneumonitis, bone marrow suppression of radiotherapy group was significantly lower than chemotherapy group and hyperthermochemoradiotherapy group with significant difference(P<0.05). Conclusion: Chemoradiotherapy combined with external high frequency thermotherapy in the treatment of advanced esophageal carcinoma further improves effective rate and survival rate with tolerated adverse reactions.

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