Abstract
The aim of this study was to evaluate the effect of the chemoradiation therapy on the incidence of postoperative complications and mortality rate in patients with locally advanced tumors of the thoracic esophagus.The study included men and women over 18 with histologically verified squamous cell carcinoma of the thoracic esophagus with TNM stage cT3-4aN0-3M0. Patients were divided into two groups: patients in a main group (n=26) received a complex treatment, patients in a second group (n=30) undergoing only surgical treatment.The first stage of treatment was performed for all 26 patients and included 2 courses of preoperative chemotherapy, followed by a chemoradiation therapy with a 44–46 Gy with weekly injections of chemotherapy. Surgical procedure (R0) was performed for 24 patients (92.3 %) in the main group and for 26 (86.6 %) in a second group.Therapeutic complications were developed in 17 (65 %) patients in a first group, while in a second group this rate was in 18 (60 %) patients from 30. The incidence of surgical complications was slightly higher in a group of patients received a complex treatment –7 (26.92 %) patients. In the surgical group such complications was noted in 6 (20 %) patients. The only death in an early postoperative period was in 1 (3.84 %) patient from the main group. The cause was sepsis and the development of multiple organic failure. There were no lethal outcomes in a surgical group.Estimating the incidence of complications, it should be noted that the use of chemoradiation therapy in the neoadjuvant regimen does not significantly affect the course of the postoperative period. The mortality rate was slightly higher in in the group of patients received complex treatment. At the same time, improvement of the ostoperative period and a reduction of mortality rate in group ofpatients undergoing complex treatment is possible due to optimization of preoperative preparation, postoperative management and competent selection of patients.
Highlights
Patients were divided into two groups: patients in a main group (n=26) received a complex treatment, patients in a second group (n=30) undergoing only surgical treatment
The first stage of treatment was performed for all 26 patients and included 2 courses of preoperative chemotherapy, followed by a chemoradiation therapy with a 44–46 Gy with weekly injections of chemotherapy
Postgraduate student, Surgical Thoracic Thoraco-Abdominal Department, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
Summary
В данное исследование, являющееся проспективным, вошло 56 пациентов с морфологически подтвержденным плоскоклеточным раком грудного отдела пищевода, включенных в клиническое испытание и получивших лечение с 2012 г. по март 2017 г. в хирургическом отделении торакоабдоминальной онкологии и отделении клинической фармакологии и химиотерапии ФГБУ «НМИЦ онкологии им. В данное исследование, являющееся проспективным, вошло 56 пациентов с морфологически подтвержденным плоскоклеточным раком грудного отдела пищевода, включенных в клиническое испытание и получивших лечение с 2012 г. В хирургическом отделении торакоабдоминальной онкологии и отделении клинической фармакологии и химиотерапии ФГБУ «НМИЦ онкологии им. Включенные в исследование, – ранее не леченные по поводу основного заболевания с распространенностью опухолевого процесса с T3-4аN0-3M0. Из 56 больных раком пищевода (РП), включенных в исследование, мужчин было 40 (71,5 %), женщин – 16 (28,6 %). Все пациенты были разделены на две группы: основную (n=26), куда вошли больные, перенесшие комплексное лечение, и контрольную (n=30), где пациенты получили только хирургическое лечение.
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