Matsuda H, Tsutsui S, Morita M, Baba K, Kitamura K, Kuwano H, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am J Clin Oncol. 1992 Dec;15(6):509-14.
Ten patients with early stage esophageal carcinoma were treated with hyperthermo-chemo-radiotherapy (HCR) without surgery. The reasons for the inoperability of these patients included medically inoperable unresectable cancers, advanced age, and/or refusal to undergo surgery. The diagnosis of early esophageal carcinoma was determined by esophagograms, endoscopy, and ultrasonography. Squamous cell carcinoma was histopathologically confirmed in each case. Each patient underwent four to nine sessions of hyperthermic treatment combined with external irradiation and chemotherapy using bleomycin; eight of these patients received additional radiation, and two terminated treatment after the HCR therapy. The tumors in all patients showed either a complete response (CR) or a partial response (PR) after HCR therapy; in two patients viable cancer cells remained, but later disappeared after additional radiation. Five patients experienced no local recurrence for 12 to 70 months and are now alive and doing well, three died of other medical conditions without any evidence of esophageal cancer, and two died of recurrent esophageal cancer 20 to 27 months after initial admission. All ten patients tolerated the HCR well without any systemic side effects. However, in two patients, esophageal erosion was recognized endoscopically. HCR therapy therefore deserves serious consideration when treating patients with small malignant lesions of the esophagus who, for various reasons, are unable to undergo surgery.
10例早期食管癌患者接受了非手术的热化疗放疗（HCR）。这些患者无法手术的原因包括医学上无法切除的癌症、高龄和/或拒绝接受手术。早期食管癌的诊断通过食管造影、内镜检查和超声检查确定。每例均经组织病理学证实为鳞状细胞癌。每位患者接受了4至9个疗程的热疗，联合外照射及使用博来霉素的化疗；其中8例患者接受了额外的放疗，2例在HCR治疗后终止治疗。所有患者的肿瘤在HCR治疗后均显示完全缓解（CR）或部分缓解（PR）；2例患者残留有存活癌细胞，但在额外放疗后消失。5例患者12至70个月无局部复发，目前存活且状况良好，3例死于其他疾病，无食管癌证据，2例在初次入院后20至27个月死于复发性食管癌。所有10例患者对HCR耐受性良好，无任何全身副作用。然而，2例患者在内镜检查时发现食管糜烂。因此，对于因各种原因无法接受手术的食管小恶性病变患者，HCR治疗值得认真考虑。
