Hölscher A H, Metzger R, Schneider P M
Klinik und Poliklinik für Viszeral- und Gefässchirurgie, Universität zu Köln.
Zentralbl Chir. 2000;125(4):319-25.
Studies on neoadjuvant therapy of esophageal cancer showed that not either preoperative chemotherapy or radiotherapy lead to a significant improvement of prognosis. However, two prospective studies showed a significant prognostic improvement after neoadjuvant combined radio/chemotherapy. Most treatment protocols include a radiation with 30-45 Gy and a simultaneous therapy with Cis-Platin/5-Fluorouracil. As an increase of perioperative morbidity and mortality has to be expected through this treatment, a careful selection of patients is necessary. Several studies have shown that mostly patients with good response benefit from this neoadjuvant therapy. The clinical response evaluation is difficult and response is best proved by classification of the histomorphologic regression of the tumor. For future research, predictive response analyses based on molecular biologic and immuno-histochemic techniques are of great importance and first differentiations by biomarkers have been detected.
对食管癌新辅助治疗的研究表明，术前化疗或放疗均未显著改善预后。然而，两项前瞻性研究显示新辅助放化疗后预后有显著改善。大多数治疗方案包括30 - 45 Gy的放疗以及顺铂/5-氟尿嘧啶同步治疗。由于这种治疗预计会增加围手术期发病率和死亡率，因此必须仔细挑选患者。多项研究表明，大多数反应良好的患者可从这种新辅助治疗中获益。临床反应评估困难，肿瘤组织形态学消退分级最能证明反应情况。对于未来的研究，基于分子生物学和免疫组织化学技术的预测反应分析非常重要，并且已经检测到生物标志物的初步区分。
