摘要
目的探讨伽马刀联合常规化疗(5-氟尿嘧啶+顺铂)治疗经过放疗后出现局部淋巴结转移的食管鳞状细胞癌患者的临床疗效与不良反应,并探讨其对免疫功能的影响。方法选取根治性放疗后出现局部淋巴转移(无远处淋巴结转移)的食管鳞状细胞癌患者120例(最后顺利完成研究105例),随机分为对照组(n=60,顺利完成55例)与观察组(n=60,顺利完成50例)。对照组给予伽马刀治疗,观察组给予伽马刀联合化疗(5-氟尿嘧啶+顺铂),均连续治疗4个疗程。治疗结束后比较2组患者的临床疗效、免疫学指标,并记录不良反应。结果观察组治疗后近期和远期疗效均优于对照组,但2组近期疗效无统计学差异(P> 0.05),远期疗效则有统计学差异(P <0.05)。治疗后2组患者的免疫学(细胞免疫、体液免疫)指标均优于治疗前,差异有统计学意义(P <0.05),且观察组优于对照组,差异有统计学意义(P <0.05)。2组患者治疗过程中均出现白细胞降低、血小板计数降低、恶心、呕吐等不良反应,2组不良反应发生率比较无统计学差异(P> 0.05)。结论伽马刀联合常规化疗(5-氟尿嘧啶+顺铂)对根治性放疗后出现局部淋巴结转移(无远处淋巴结转移)的食管癌患者具有很好的临床疗效。
Objective To observe patients with esophageal squamous cell carcinoma[ ESCC,without distant lymph node metastasis( LM)], who had local LM after radiotherapy and therefore were treated with gamma knife combined with conventional chemotherapy( 5-fluorouracil + cisplatin);to evaluate the clinical efficacy in these patients after treatment;and to record adverse reactions. Methods A total of 120 patients with ESCC who underwent radical radiotherapy( with local LM thereafter) without distant LM were randomly divided into control (n = 60;55 completed the procedure successfully) and observation( n = 60;50 completed the procedure successfully) groups. The control group was treated with gamma knife,whereas the observation group was given chemotherapy( 5-fluorouracil and cisplatin) in addition to the basic gamma knife for 4 courses of treatment. The clinical efficacy of the two groups was compared at the end of treatment,followed by detection of immunological indicators( cellular and humoral immunity) and recording of adverse reactions. Results After treatment, the short-term clinical efficacy in the observation group was found to be better than that in the control group but held no statistical significance( P > 0.05). However,the long-term clinical efficacy was significantly enhanced in the observation group than in the control group( P < 0.05). After treatment,the immunological indicators( cellular and humoral immunity) of the two groups were substantially improved post treatment( P < 0.05),exhibiting remarkable enhancement in the observation group compared with the control group( P < 0.05). Remission rate of the clinical symptoms did not vary significantly between the two groups after treatment( P > 0.05). Adverse reactions such as leukopenia,decreased platelet count,nausea,and vomiting were observed during the course of treatment for both the groups, lacking any significant difference( P > 0.05). Conclusion Gamma knife coupled with chemotherapy( 5-fluorouracil + cisplatin) can improve the treatment efficiency in ESCC pa
作者
李雨微
张曙光
LI Yuwei;ZHANG Shuguang(Department of Thoracic Surgery,The First Hospital,China Medical University,Shenyang 110001,China)
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2019年第3期205-209,215,共6页
Journal of China Medical University
基金
国家自然科学基金青年科学基金(81201890)
辽宁省自然科学基金(LK201614)
关键词
伽马刀
化学治疗
食管癌
临床疗效
gamma knife
chemotherapy
esophageal carcinoma
clinical efficacy
