Adenis A, Catala P, Mirabel X, Triboulet J P
Département de cancérologie digestive et urologique, Centre Oscar-Lambret, rue Frédéric-Combemale, 59020 Lille Cedex.
Bull Cancer. 2001 Oct;88(10):965-83.
Although slightly declining in France, the incidence rate of esophageal cancer remains amongst the highest seen in Europe, especially in Brittany, in the North as well as in Normandy. Alcohol and tobacco consumption remains the main risk factor for esophageal cancer in Western countries. Positive diagnosis of esophageal cancer is made by upper gastrointestinal endoscopy combined with biopsies. At present, surgery and definitive radiochemotherapy are two therapeutic options offering a chance to cure even though surgery remains the more frequently used treatment. Five-year-survival rate after apparently curative surgical resection or definitive radiochemotherapy remains only 20% in most population-based series. The studies that have examined the role of adjuvant treatments after surgical resection, have failed to demonstrate any improvement in overall or relapse-free survival. The pre-operative cytotoxic combined modality approaches with radiochemotherapy have shown improved relapse-free survival but still remains experimental. Finally, the symptomatic treatment of dysphagia might not be ignored either in locally, locally advanced, or in metastatic disease.
尽管法国的食管癌发病率略有下降,但仍位居欧洲最高之列,尤其是在布列塔尼、北部以及诺曼底地区。在西方国家,酒精和烟草消费仍然是食管癌的主要危险因素。食管癌的确诊通过上消化道内镜检查并结合活检来进行。目前,手术和确定性放化疗是两种提供治愈机会的治疗选择,尽管手术仍然是更常用的治疗方法。在大多数基于人群的系列研究中,根治性手术切除或确定性放化疗后的五年生存率仅为20%。那些研究手术切除后辅助治疗作用的研究未能证明在总生存期或无复发生存期方面有任何改善。术前细胞毒性联合放化疗方法已显示出无复发生存期有所改善,但仍处于试验阶段。最后,吞咽困难的对症治疗在局部、局部晚期或转移性疾病中也不容忽视。