The curative effect of neoadjuvant radiotherapy and chemotherapy combined with surgery for middle and late esophageal squamous cell carcinoma

Abstract

Objective To understand the efficacy of neoadjuvant radiotherapy and chemotherapy combined with surgery in the treatment of middle segment esophageal squamous cell carcinoma. Methods 100 cases of mesoesophageal squamous cell carcinoma admitted from July 2011 to August 2013 were randomly divided into study group and control group, with 50 cases per group. The study group’s neoadjuvant radiotherapy and chemotherapy program was 2 Gy, which was performed with 6 to 8 targets for tongue titration intensity radiotherapy, once a day, 5 times a week, with a total dose of 40 Gy. TP regimen was administered synchronously on the 1st to 4th and 25th to 28th days after radiotherapy. The radical resection of esophageal carcinoma with two incisions in right chest and upper abdomen was performed 3 to 5 weeks after the end of radiotherapy and chemotherapy. Surgical complications, pathologic factors and 1, 3, 5-year survival rates were observed. Results In terms of postoperative complications, the incidence of pulmonary infection in the study group was higher than that in the control group (χ2=5.263, P=0.022). The incidence of anastomotic leakage in the study group was higher than that in the control group, with no statistical difference (χ2=0.344, P=0.558). The rate of recurrent laryngeal nerve injury in the study group was lower than that in the control group, with no statistical difference (χ2=1.042, P=0.307). The total incidence of postoperative complications in the study group was higher than that in the control group, with no statistical difference (χ2=3.326, P=0.068). In terms of pathological remission rate, the study group was significantly superior to the control group, with statistically significant differences (χ2=32.750, P=0.001). In terms of postoperative survival rate, the 1-year survival rate in the study group was higher than that in the control group, with no statistical difference (χ2=3.475, P=0.062). Survival rates of 3 years (χ2=5.769, P=0.016), and 5 years (χ2=4.762, P=0.029). were statistically higher in the survival study group than in the control group. Conclusion Neoadjuvant radiotherapy and chemotherapy combined with surgery can significantly prolong 3-year and 5-year survival rates in patients with middle thoracic esophageal squamous cell carcinoma. Key words: Esophageal squamous carcinoma; Neoadjuvant radiotherapy and chemotherapy; Surgical treatment