Clinical Observation On Efficacy Of Esophageal Carcinoma Treated By Brucea Javanica Oil-injection Combined With Concurrent Radiochemotherapy

Objective:To observe and investigate the efficacy and safety of the combined treatment of Brucea javanica oil emulsion injection and TP chemotherapy with intensity-modulated radiation therapy(IMRT)in the treatment of esophageal cancer,providing reference basis for the promotion and application of integrated traditional Chinese and Western medicine in the treatment of cancer.Methods:60 esophageal cancer patients who met the criteria were randomly divided into treatment group and control group,30 cases in each group.The treatment group received simultaneous TP chemotherapy with IMRT and was treated with intravenous infusion of Brucea javanica oil emulsion injection 30ml once a day in the whole process of concurrent radio chemotherapy.In the control group,the same concurrent radiotherapy and chemotherapy protocol was used alone.TP chemotherapy is a cycle of 21 days,with 2 cycles in total.IMRT:'GTV60-64Gy/28-30 times,CTV54Gy/28times,PTV54Gy/28times,IMRT started 5 times a week for 6-7 weeks starting from the first day of TP chemotherapy.During the course of treatment and before and after treatment,the short-term efficacy,TCM symptoms,side effects of chemoradiotherapy,physical strength,weight,and quality of life of the two groups of patients were to be observed and evaluated.Results:(1)In terms of short-term efficacy,the effective rates of the treatment group and the control group were 60%and 53.33%,respectively.The treatment group was more effective than the control group,but the difference was not statistically significant(P>0.05).(2)In the aspect of TCM symptoms,the improvement rate of the treatment group in terms of dysphagia,chest pain or back pain,weary,and total score of TCM symptoms was significantly higher than that of the control group(P<0.05).There was no significant difference between the two groups in terms of swallowing pain,foreign body sensation and hoarseness(P>0.05).(3)In the side effects of radiochemotherapy,the incidence of myelosuppression,gastrointestinal reactions and radioactivity was significantly reduced in the treatment group compared with the control group(P<0.05).There was no significant difference between the two groups in peripheral nerve toxicity,hair loss and oral mucosal reaction(P>0.05).(4)The quality of life evaluation was comprehensively evaluated by three aspects:KPS physical strength score,weight and quality of life core scale EORTC QLQ-C30 score.The stable rate of KPS physical stabilities before and after treatment was 86.67%and 73.33%,respectively.The treatment group was superior to the control group(P<0.05).The stable rate of body weight changes before and after treatment in the two groups was 56.67%and 40.00%,respectively,and the treatment group was superior to the control group(P<0.05).EORTC QLQ-C30 score comparison before and after treatment,two groups in terms of physical function,role function,emotional function,social function and physical symptoms dimensions,scores after treatment were significantly improved than before treatment(P<0.05),while cognitive function and health-related economic dimensions were not significantly different(P>0.05).Comparing scores after treatment between the two groups,in the role of function,emotional function and physical symptoms dimensions,the treatment group compared to the control group significantly improved scores after treatment(P<0.05),while there was no significant difference between the two groups in physical function,cognitive function,social function,and health-related economic dimensions(P>0.05).Conclusion:The combined application of Brucea javanica oil emulsion injection in the treatment of esophageal cancer with TP chemotherapy with IMRT can improve the symptoms of TCM patients,reduce the toxic and side effects of radiotherapy and chemotherapy,and improve the quality of life.