Evaluation Of Clinical Efficacy Of Hyperthermia Combined With Neoadjuvant Chemoradiation In The Treatment Of Advanced Esophageal Cancer

Objective:Esophageal cancer is a malignant tumor that occurs in the esophageal mucosal epithelium.The histological types are mainly divided into esophageal squamous cell carcinoma and esophageal adenocarcinoma.Affected by factors such as heredity,eating habits and living environment,there are obvious regional differences.Most patients have been in advanced stages and often show esophageal stenosis,obstruction,barium meal angiography difficult to pass or intraoperative lymph node metastasis.Surgery is the preferred method for the treatment of early esophageal cancer.Progressive esophageal cancer is mainly treated by radiotherapy and chemotherapy,but the 5-year survival rate is still less than 20%.It is an urgent to seek new treatments to improve the prognosis and quality of life of advanced esophageal cancer.Neoadjuvant chemoradiation is the implementation of radiotherapy or chemotherapy before surgery,which can reduce the preoperative pathological stage and improve the surgical resection rate.Hyperthermia causes the death of tumor cells by heating,without harming normal organs,so as to achieve the purpose of treating tumors.In recent years,neoadjuvant chemoradiation and hyperthermia have made some progress in the treatment of advanced esophageal cancer.In this study,hyperthermia combined with neoadjuvant chemoradiation has been used to treat advanced esophageal cancer,and its efficacy and safety have been observed.Methods:The study selected seventy-two eligible advanced esophageal cancer patients from the First Affiliated Hospital of Zhengzhou University.According to different treatment methods,they were randomly divided into control group and observation group,with 36 cases in each group.Observation group:intensity modulated radiation therapy(IMRT),1.8 Gy/d,5 d/week,total dose of 45 Gy;first day of radiotherapy with concurrent chemotherapy,regimen of cisplatin 30 mg/m~2,d1 to 3+Fluorouracil 500 mg/m~2,d1 to 5,21 d repeat,2 cycles;simultaneous hyperthermia,performed 30 minutes after radiotherapy,45 minutes each time,2 days for 1 time,20times for a course of treatment.Control group:The concurrent radiotherapy and chemotherapy protocol was the same as the observation group.The toxic side effects of all patients during the treatment were given symptomatic treatment.At the end of treatment,data were collected to observe and compare the short-term efficacy,adverse reactions,and long-term survival of the two groups of patients.Results:All patients can complete the relevant treatment.Among them,the observation group:complete remission(CR)is eight cases,partial remission(PR)is twenty-two cases,stable(SD)is four cases,progression(PD)is two cases,the total effective rate(ORR)is 83.3%;control group:complete remission(CR)is six cases,partial remission(PR)is sixteen cases,stable(SD)is twelve cases,progression(PD)is two cases,the total effective rate(ORR)is 61.1%.The ORR of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The main adverse reactions were hematological toxicity,acute gastrointestinal reaction,and esophagitis.The grade 1 to grade 2 were the main adverse reactions.After clinical intervention,all patients were relieved.The overall incidence of adverse reactions in the two groups of patients was comparable,with no statistical difference.Significance(P>0.05).After two years of follow-up,the overall survival rate of the two groups was compared(77.8%VS 61.1%),and the difference was not statistically significant(P>0.05).However,the disease-free survival rate in the observation group(72.2%)was significantly higher than that in the control group(47.2%)(P<0.05).Conclusions:Hyperthermia combined with neoadjuvant chemo-radiotherapy in the treatment of advanced esophageal cancer,compared with neoadjuvant chemotherapy and radiotherapy alone,can improve the efficiency of the recent and long-term disease-free survival.Hyperthermia failed to increase the incidence of adverse reactions during neoadjuvant chemoradiation.It was safe and reliable and worthy of clinical application.