Clinical Research On Neoadjuvant Chemoradiotherapy Combined With Surgery In The Treatment Of Locally Advanced Esophageal Carcinoma

Objective Esophageal cancer is the highest incidence and mortality of upper gastrointestinal cancer in China.Although new treatment methods and means are emerging,the overall therapeutic effect of esophageal cancer is not ideal,especially for locally advanced esophageal carcinoma.Single treatment can not significantly improve the survival rate of the patients,so comprehensive treatment can help improve the prognosis of patients with esophageal carcinoma.The purpose of this study was to explore the safety,feasibility and efficacy of neoadjuvant chemoradiotherapy combined with surgery for locally advanced esophageal carcinoma.Methods A prospective group of 60 patients with locally advanced esophageal carcinoma was enrolled in the Department of Thoracic Surgery,Fudan University Cancer Hospital from January 2013 to December 2013.These patients were randomly divided into the new adjuvant treatment group and the direct operation group,30 cases in each group.The new adjuvant treatment group was treated with neoadjuvant chemoradiotherapy combined with surgery,while the direct operation group was treated with surgery directly.According to the pathology and recovery,the patients in the both groups continued to receive comprehensive treatment on the principle of tumor.The clinical data,pathological results and prognosis of the two groups were compared.Results There were not significant differences in operation time,intraoperative bleeding volume,postoperative hospital stay,postoperative complications and incidence of anastomotic stoma between the new adjuvant treatment group and the direct operation group(P > 0.05).There were significant differences between the new adjuvant treatment group and the direct operation group in lymph node metastasis rates(26.67% vs 53.3%),degrees of lymph node metastasis(3.65% vs 7.24%)and R0 resection rates(96.7% vs 73.3%)(P<0.05).The three-year survival rates of the new adjuvant treatment group and the direct operation group were 56.67% and 14.33%,respectively,with significant difference(P < 0.05).Conclusion Neoadjuvant chemoradiotherapy combined with surgery can increase the resection rate and improve prognosis in patients with locally advanced esophageal carcinoma,without increasing the complications of surgery.It has a positive significance in improving the efficacy of the patients.