中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

术后治疗能否给已经接受 TP 方案新辅助化疗的局部进展期食管鳞癌患者带来生存获益?

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目的 探讨术后辅助治疗能否给已经接受 TP 方案新辅助化疗的局部进展期食管鳞癌患者带来生存获益。 方法 回顾性分析 2007 年 1 月到 2016 年 12 月间我科接受紫杉醇+顺铂(TP)方案新辅助化疗并接受食管癌手术治疗的 115 例局部进展期食管鳞状细胞癌患者的临床资料,将患者分成两组:未接受治疗组,54 例,男 47 例、女 7 例;接受治疗组,61 例(其中术后化疗 31 例,术后放疗 14 例,术后放化疗 16 例),男 52 例、女 9 例。 结果 未接受术后治疗组 5 年估计无病生存率是 54.7%,5 年估计总生存率是 55.3%。而接受术后治疗组的中位无病生存期是 46.0 个月(95% CI 22.9~69.1),5 年估计无病生存率是 42.3%;中位总生存期是 68.0 个月(95% CI 33.0~103.0),5 年估计总生存率分别是 51.3%。Kaplan-Meier 生存分析显示两组患者的无病生存(P=0.641)和总生存(P=0.757)之间的差异均无统计学意义。此外,利用 Cox 比例风险模型方法对各个亚组进行分析同样显示术后治疗没有给患者带来显著的生存获益(P 值均>0.05)。 结论 术后治疗并不能给已经接受了 TP 方案新辅助化疗的食管鳞癌患者带来生存获益。

Objective To investigate whether postoperative therapy can bring survival benefits to patients with locally advanced esophageal squamous cell carcinoma who have received neoadjuvant chemotherapy with TP regimen. Methods We retrospectively reviewed clinical data of 115 patients with locally advanced esophageal squamous cell carcinoma who received neoadjuvant chemotherapy with TP regimen and underwent esophagectomy in our hospital from January 2007 through December 2016. Patients were divided into two groups including a non-receiving treatment group (54 patients with 47 males and 7 females) and a receiving treatment group (61 patients with 52 males and 9 females). There were 31 patients with postoperative chemotherapy, 14 with postoperative radiotherapy, and 16 with postoperative chemotherapy and radiotherapy in the receiving treatment group. Results In the non-receiving group, the 5-year median disease free survival (DFS) rate was 54.7%, and the 5-year overall survival (OS) rate was 55.3%. In the receiving group, the median DFS was 46.0 months (95% CI 22.9–69.1), the 5-year DFS rate was 42.3%; and the median OS was 68.0 months (95% CI 33.0–103.0), the 5-year OS rate was 51.3%. Furthermore, there were no statistical differences between these two groups with regard to DFS (P=0.641) or OS (P=0.757) using Kaplan-meier method. Besides, in each subgroup, the results of Cox proportional hazard model analysis showed postoperative treatment did not improve survival (P>0.05, respectively). Conclusion Postoperative treatment does not bring survival benefits to patients with esophageal squamous cell carcinoma who have received neoadjuvant chemotherapy with TP regimen.

关键词: 局部进展期; 食管鳞状细胞癌; 新辅助化疗; 术后治疗 TP 方案

Key words: Locally advanced esophageal squamous cell carcinoma; neoadjuvant chemotherapy; postoperative treatment; TP regimen

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