Evaluation Of Curative Efficacy And Safety Of Neoadjuvant Chemoradiation For The Phase Ⅲ Cardiac Carcinoma

Objective: Evaluate the recent curative effect and security of the paclitaxel plus carboplatin(TP)neoadjuvant chemoradiation scheme for the phase Ⅲcardiac carcinoma to explore the optimized scheme of neoadjuvant chemoradiation for phase Ⅲ cardiac carcinoma.Methods: Select partial phase Ⅲ cardiac carcinoma patients as the research object,a total of 35 cases,and the patients were separately treated by TP weekly neoadjuvant chemotherapy(chemotherapy group)and TP weekly neoadjuvant chemoradiation(chemoradiation group).Evaluate the curative effect of two neoadjuvant therapies for patients of the phase Ⅲcardiac carcinoma by comparing the two groups after neoadjuvant therapy for patients with the R0 resection rate of surgery,clinical staging,efficient,clinical symptoms and the change of the morphology.Evaluate the safety of two neoadjuvant therapies for patients of the phase Ⅲ cardiac carcinoma by comparing the two groups of surgical mortality and incidence of postoperative complications and the side effects of chemoradiation.Results: There were 19 cases in chemotherapy group,18 cases in chemoradiation group.In chemotherapy group,13 cases achieved R0 resected,and the R0 resection rate was 68.42%.In chemoradiation group,17 cases achieved R0 resected,and the R0 resection rate was 94.44%.The difference between the two groups was statistically significant(p<0.05).In chemotherapy group,clinical stage decline in 13 cases(68.42%),without change in 6 cases(31.58%).In chemoradiation group,clinical stage declined in 17 cases(94.44%),without change in 1 case(5.56%).The difference between the two groups was statistically significant(p<0.05).In chemotherapy group,effective rate was 68.42%,with complete remission in 1 case(5.26%),partial remission in 12 cases(63.16%),stable disease in6 cases(31.58%),without progression disease case;In chemoradiation group,effective rate was 94.44%,with complete remission in 2 case(16.67%),partial remission in 15 cases(83.33%),stable disease in 1 case(5.56%),without progression disease case.The difference between the two groups was statistically significant(p<0.05).There was no operative deaths,and complications such as bleeding,obstruction,anastomotic stenosis,anastomotic fistula and wound infection in two groups.The major level 3-4adverse reactions in chemotherapy group included alopecia in 8 cases(42.11%),leukopenia in 1 case(5.26%),neutropenia in 1 case(5.26%).The major level 3-4 adverse reactions in chemotherapy group included alopecia in 10 cases(55.56%),leukopenia in 2 cases(11.11%),neutropenia in 2 cases(11.11%),gastric mucosal injury in 1 case(5.56%).All the adverse reactions reduced or disappeared after symptomatic treatment,without deaths caused by chemoradiation.Conclusion: 1.Both the paclitaxel plus carboplatin(TP)single week neoadjuvant chemotherapy scheme and TP single week neoadjuvant chemoradiation scheme can reduce the clinical stage of cardiac carcinoma,while the effect of TP single week neoadjuvant chemoradiation scheme in reducing clinical stage is better than that of TP single week adjuvant chemotherapy scheme.2.The effect of TP single week neoadjuvant chemoradiation scheme in improving the cardiac carcinoma patients’ R0 resection rate is batter than that of TP single week adjuvant chemotherapy scheme.3.TP single week neoadjuvant chemoradiation scheme is a safety neoadjuvant therapy because it doesn’t increase the risk of dying from operation and postoperative complication rates,and patients who treated by this scheme can easily tolerate.4.TP single week neoadjuvant chemoradiation scheme can be used as a optimized neoadjuvant therapy for the phase Ⅲ cardiac carcinoma.