Adjuvant chemotherapy with 5-fluorouracil and cisplatin in lymph node-positive thoracic esophageal squamous cell carcinoma
Adjuvant chemotherapy with 5-fluorouracil and cisplatin in lymph node-positive thoracic esophageal squamous cell carcinoma
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DOI：
10.1016/j.athoracsur.2005.03.058
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发表时间：
2005-10-01
影响因子：
4.6
通讯作者：
Shim, YM
中科院分区：
文献类型：
--
作者：
Lee, J;Lee, KE;Shim, YM
背景。在本研究中，我们探讨了辅助化疗在淋巴结阳性切除的胸段食管鳞状细胞癌患者中的有效性。对N1例食管癌根治性切除患者的术后化疗进行前瞻性研究，并与历史对照组进行复发率、失败方式、无病生存率、总生存率的比较。术后化疗由顺铂（60mg /m(2)静脉注射）和5-氟尿嘧啶（1000mg /m2 /天）连续输注4天组成。每3周给药3个周期。从1998年1月到2003年1月，共有40名患者在三星首尔医院接受了辅助化疗。历史对照组为52例同期行根治性切除而非辅助化疗的患者。辅助治疗组3年无病生存率为47.6%，对照组为35.6% （p = 0.049）。辅助治疗组5年总生存率为50.7%，对照组为43.7% （p = 0.228）。阳性淋巴结数（p = 0.008）和辅助化疗（p = 0.030）是肿瘤复发的显著预测因素。这项研究表明。术后化疗可延长淋巴结阳性、治愈性切除食管癌患者的无病生存期。食管癌患者的术后治疗方式应根据淋巴结状况确定，如果食管癌淋巴结阳性，则需要进行随机III期临床试验，使用辅助化疗。
Background. In this study we explored the effectiveness of adjuvant chemotherapy in node-positive, resected thoracic esophageal squamous cell carcinoma patients.Methods. A prospective study of postoperative chemotherapy in N1 esophageal cancer patients who received curative resection was conducted and compared with the historical control group in regard to recurrence rate, patterns of failure, disease-free survival rate, and overall survival rate. The postoperative chemotherapy consisted of cisplatin (60 mg/m(2) intravenously) and 5-fluorouracil (1,000 mg/m2 per day) in a continuous infusion for 4 days. Three cycles were administered at 3-week intervals.Results. Forty patients were accrued from January 1998 to January 2003 at Samsung Medical Center for adjuvant chemotherapy. The historical control, group consisted of 52 patients who received curative resection but not adjuvant chemotherapy during the same period of time. The 3-year disease-free survival rate was 47.6% in the adjuvant group and 35.6% in the control group (p = 0.049). The estimated 5-year overall survival rates were 50.7% in the adjuvant group and 43.7% in the control group (p = 0.228). The significant predictive factors for tumor recurrence were the number of positive lymph nodes (p 0.008) and the adjuvant chemotherapy (p = 0.030).Conclusions. This study suggests that the. postoperative chemotherapy may prolong disease-free survival in lymph node-positive, curatively resected esophageal cancer patients. The postoperative treatment modality for esophageal cancer patients should be determined according to the lymph node status and a randomized phase III clinical trial is warranted using adjuvant chemotherapy if the esophageal cancer is lymph node-positive.