Study on multimodal treatment for a locally-advanced esophageal cancer. Surgery, is it necessary?

局部晚期食管癌多模式治疗研究。

• 批准号: 11671292
• 负责人: FUJITA Hiromasa
• 金额: $ 1.79万
• 依托单位: KURUME UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11671292/
• 关键词: Esophageal cancer; Locally-advanced (T4) cancer; Multimodal treatment; Induction chemoradiotherapy; Daily chemotherapy; Hyperfruction radiotherapy; Informed consent; Prospective trial; 術前照射化学療法

1. Purpose : To evaluate the necessity of esophageal surgery after chemoradiotherapy for a locally- advanced (T4) esophageal cancer2. Methods : a prospective non-randomized trial based on informed consent comparing chemoradiotherapy followed by surgery (CRTx+S) versus chemoradiotherapy alone (CRTx-alone).3. Patients' criteria : (1) T4 squamous cell carcinoma in the thoracic esophagus, (2) without distant metastasis (M0), (3) less than 75 year-old, (4) Performance status=0〜2, (5) without active other primary cancer(s), (6) informed consent.4. Results : Fifty-three patients were enrolled from 1994 to 2002, 29 in the CRTx+S group and 24 in the CRTx-alone group. The responders (CR/PR) to the 1^<st> course of chemoradiotherapy - induction chemoradiotherapy - were 31 (58%), and the non-responders (NC/PD) were 22 (42%). The survival rates of patients with a T4 esophageal cancer were not correlated to surgery, but to the effect of chemoradiotherapy. In responders to chemoradiotherapy, there was no difference in the survival rates between the CRTx+S group and the CRTx-alone group, while in non-responders, the survival rates were better in the CRTx+S group than in the CRTx- alone group.5. Conclusions : Surgery is not necessary for the responders to chemoradiotherapy, while it is necessary for the non-responders.

1.目的：评估局部晚期（T4）食管癌放化疗后食管手术的必要性2。研究方法：一项基于知情同意的前瞻性非随机试验，比较了放化疗后手术（CRTx+S）与单纯放化疗（CRTx-单独）。患者标准：（1）胸段食管T4鳞状细胞癌，（2）无远处转移（M0），（3）小于75岁，（4）体力状态=0 ~ 2，（5）无活动性其他原发癌，（6）知情同意。结果：从1994年至2002年，共入组53例患者，其中CRTx+S组29例，CRTx单药组24例。对第1个疗程的放化疗-诱导放化疗-有反应者（CR/PR）<st>为31例（58%），无反应者（NC/PD）为22例（42%）。T4食管癌患者的生存率与手术无关，但与放化疗的效果有关。在对放化疗有反应的患者中，CRTx+S组和CRTx单药组的生存率无差异，而在无反应的患者中，CRTx+S组的生存率优于CRTx单药组。结论：对放化疗有效者不需要手术治疗，而对无效者则需要手术治疗。

项目成果

藤田博正: "進行食道癌の治療"久留米医学会雑誌. 64(5・6). 125-129 (2001)

藤田弘正：“晚期食管癌的治疗”久留米医学会杂志64（5・6）125-129（2001）。

藤田博正: "他臓器浸潤(T_4)食道癌に対するChemoradiotherapyの新展開"癌と化学療法. 27(13). 2016-2022 (2000)

Hiromasa Fujita：“侵袭其他器官的食管癌放化疗的新进展（T_4）”癌症与化疗2016-2022（2000）。

藤田博正ほか: "食道癌治療の現況と将来展望"日本気管食道科学会会報. 53(2). 140 (2002)

Hiromasa Fujita 等：“食管癌治疗的现状和未来展望”日本气管食管科学学会通报 53(2) 140 (2002)。

藤田博正 ほか: "局所進行食道癌の集学的治療"臨床外科. 57(2). 177-184 (2002)

Hiromasa Fujita 等：“局部晚期食管癌的多学科治疗”临床外科 57(2) (2002)。

I Shima,et al.: "Induction therapy for esophageal cancer in advanced stage: A prospective study"The Canadian Journal of Gastroenterology. 12(Suppl). 78B (1998)

I Shima等人：“晚期食管癌的诱导治疗：一项前瞻性研究”加拿大胃肠病学杂志。