[Chemoradiotherapy for esophageal cancer].
[Chemoradiotherapy for esophageal cancer].
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发表时间：
2003-07
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通讯作者：
H. Fujita;S. Sueyoshi;Toshiaki Tanaka;H. Sasahara;S. Matono;H. Yamana;K. Shirouzu;G. Suzuki;N. Hayabuchi
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作者：
H. Fujita;S. Sueyoshi;Toshiaki Tanaka;H. Sasahara;S. Matono;H. Yamana;K. Shirouzu;G. Suzuki;N. Hayabuchi
由于黏膜(T1a)食道癌可以通过内窥镜治疗得到很好的控制，所以不建议采用放化疗(CRTX)。然而，对于粘膜下(T1b，N0)食道癌，CRTX可能是一线治疗，因为它可以提供良好的应答率，具有与食道切除术后相当的出色生存率。确定的CRTX也是T4食道癌的一线治疗药物，因为在我们的试验中，CRTX手术和非手术CRTX的存活率没有差异。食道切除术仅适用于无反应者或复发挽救手术。在我们的系列中，对于潜在可切除(T2-T3)的食道癌患者，食道切除术比CRTX提供了更长的存活率。然而，对于CRTX治疗T2-T3食道癌的疗效仍存在争议。据国家癌症中心医院东部集团报道，CRTX最终提供了与食道切除术相同的存活率。需要一项前瞻性试验，比较T2-T3食道癌切除后和CRTX后的存活率。
Since mucosal (T1a) esophageal cancer is well controlled by endoscopic treatment, chemoradiotherapy (CRTx) is not indicated. However, for a submucosal (T1b, N0) esophageal cancer, CRTx may be the first line of treatment, since it can provide a good response rate, with an excellent survival rate comparable to that after esophagectomy. Definitive CRTx is also in the first line of treatment for a T4 esophageal cancer, because there was no difference in the survival rate between CRTx with surgery and CRTx without surgery in our trial. Esophagectomy is indicated only for non-responders or recurrence-salvage surgery. For patients with a potentially-resectable (T2-T3) esophageal cancer, esophagectomy offered a longer survival rate than CRTx did, in our series. However, there remains controversy over the efficacy of CRTx for a T2-T3 esophageal cancer. It has been reported by the National Cancer Center Hospital East Group that definitive CRTx provided the same survival rate as esophagectomy. A prospective trial comparing the survival rate after esophagectomy and that after CRTx for a T2-T3 esophageal cancer is needed.