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目的:研究新辅助放化疗在食管癌和食管及胃交界癌临床治疗中的疗效和预后情况.方法:选取2012年3月至2014年3月于隆尧县医院接受治疗的食管癌和食管及胃交界癌患者共292例.根据随机数字表法,将所有患者随机分为联合组和对照组各146例.联合组给予术前新辅助放化疗联合手术治疗方案,对照组单纯给予手术治疗,分析两组的治疗效果及预后情况.结果:联合组患者新辅助放化疗前平均肿瘤直径(5.9±2.8)cm显著高于新辅助放化疗后(3.5±1.2)cm,差异有统计学意义(t=3.527,P＜0.05);联合组新辅助放化疗后达到完全缓解标准者15例,部分缓解68例,疾病稳定46例,疾病进展17例,总有效率为56.8％,其中鳞癌(55.7％)与腺癌(59.2％)之间的有效缓解率差异无统计学意义(P＞0.05);部分患者在新辅助放化疗期间出现了不良反应,但未有3级毒性反应出现,且给予对症支持治疗后,均能快速好转并按计划完成整个放化疗;两组患者术后并发症发生情况对比差异均无统计学意义(P＞0.05);联合组随访第2年(66.4％)和第3年(44.5％)的生存率均显著高于对照组的43.2％和26.7％,差异有统计学意义(P＜0.05).结论:术前辅助放化疗能够有效缓解食管癌和食管及胃交界癌病情,缩小肿瘤体积,提高手术治疗效果,显著改善食管癌食管及胃交界癌患者的生存率,且不会增加术后并发症的发生率,耐受性较好.“,”Objective:To study the curative effect and prognosis of neoadjuvant chemoradiotherapy in clinical treatment of esophageal and cardiac cancer.Methods:A total of 292 patients with esophageal and cardiac cancer in Longyao County Hospital were selected from March 2012 to March 2014.Using the random number table method,all patients were randomly divided into the combined treatment group and the control group,with 146 cases in each group.The combined treatment group was given preoperative neoadjuvant radiotherapy and chemotherapy combined with surgical treatment,and the control group was given surgery alone.The therapeutic effects and prognosis of the two groups were analyzed.Results:The mean tumor diameter in the combined treatment group(5.9±2.8) cm was significantly higher than that in the neoadjuvant chemotherapy group (3.5±1.2) cm (t=3.527,P＜0.05).The total effective rate was 56.8％,including 15 cases of CR,68 PR,46 SD and 17 PD.The effective remission rate had no significant difference between squamous cell carcinoma (55.7％) and adenocarcinoma (59.2％) (P＞0.05).Some patients in the new adjuvant chemotherapy group developed toxic reactions,but without third grade toxic reactions,and improved soon when given appropriate symptomatic support and completed the entire course of radiotherapy and chemotherapy as planned.There was no significant difference between the two groups in postoperative complications (P＞0.05).The survival rates of the combined treatment group in the second year (66.4％) and the third year (44.5％) were significantly higher than those of the control group (43.2％ and 26.7％) (P＜0.05).Conclusion:Preoperative adjuvant radiotherapy and chemotherapy can effectively relieve the condition of patients with esophageal and cardiac cancer,reduce tumor volume,improve the effect of surgical treatment,significantly improve the survival rate,and will not increase the incidence of postoperative complications,with good tolerability.