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目的探讨热疗联合多西紫杉醇+卡铂同期放疗对中晚期食管癌的临床疗效及其对血清血管内皮生长因子的影响。方法将50例中晚期食管癌患者随机分为对照组25例和试验组25例。对照组予以静脉滴注75 mg·m-2多西紫杉醇,1 h,第1天+静脉滴注25 mg·m-2卡铂,第1~3天;试验组在对照组的基础上,同期用NRL-004肿瘤热疗系统进行热疗,热疗输出功率900~1200 W,每周两次。2组患者一个周期均为28 d,均接受两个周期治疗。比较2组患者的近期临床疗效、治疗前后的血清血管内皮生长因子水平和生存质量评分以及不良反应发生率。结果治疗后,试验组总有效率84.00%显著高于对照组68.00%(P<0.05)。治疗后,试验组血清血管内皮生长因子水平显著下降,对照组血清血管内皮生长因子水平有略微下降,且试验组显著低于对照组(P<0.05)。治疗后,试验组生存质量评分(54.32±9.42)显著高于对照组(42.04±10.51)(P<0.05)。试验组的主要不良反应为恶心呕吐和脱发,发生率分别为48.00%和56.00%;对照组的主要不良反应为恶心呕吐和脱发,发生率分别为52.00%和64.00%,2组比较差异有统计学意义(P<0.05)。结论热疗联合多西紫杉醇+卡铂同期放疗治疗中晚期食管癌的近期临床疗效显著,能有效地降低血清血管内皮生长因子水平,而且不良反应较少,值得在临床中推荐。
Objective To investigate the clinical efficacy of hyperthermia in combination with docetaxel and carboplatin in the treatment of advanced esophageal cancer and its effect on serum vascular endothelial growth factor. Methods Fifty patients with advanced esophageal cancer were randomly divided into control group (n = 25) and experimental group (n = 25). The control group was given docetaxel 75 mg · m-2 intravenously, 1 h, on the first day + intravenous infusion of 25 mg · m-2 carboplatin, 1 to 3 days; on the basis of the control group, The same period with NRL-004 tumor hyperthermia system for hyperthermia, hyperthermia output power 900 ~ 1200 W, twice a week. One cycle of two groups of patients were 28 days, both were treated for two cycles. The clinical efficacy, serum vascular endothelial growth factor level and quality of life before and after treatment were compared between two groups of patients and the incidence of adverse reactions. Results After treatment, the total effective rate in the experimental group was 84.00%, significantly higher than that in the control group (68.00%, P <0.05). After treatment, the level of serum vascular endothelial growth factor in the experimental group decreased significantly, but the level of serum vascular endothelial growth factor in the control group decreased slightly, and the experimental group was significantly lower than the control group (P <0.05). After treatment, the quality of life in the test group (54.32 ± 9.42) was significantly higher than that in the control group (42.04 ± 10.51) (P <0.05). The main adverse reactions in the experimental group were nausea, vomiting and alopecia, the incidence rates were 48.00% and 56.00% respectively. The main adverse reactions of the control group were nausea, vomiting and hair loss, the incidence rates were 52.00% and 64.00% respectively. There were statistically significant differences between the two groups Significance (P <0.05). Conclusions The short-term clinical curative effect of hyperthermia combined with docetaxel and carboplatin concurrent radiotherapy for advanced esophageal cancer is significant. It can effectively reduce the serum level of vascular endothelial growth factor and has fewer side effects. It is worth recommending in clinic.