Ganem G, Raoul Y, Goudier M J, Dubray B, Colin P, Extra J M, Hennequin C, Michel-Langlet P, Vignoud J, Bardet E
Centre d'oncoradiothérapie et d'hématologie Victor-Hugo, Le Mans, France.
Bull Cancer. 1992;79(8):735-50.
Prognosis of esophageal cancer is very poor. Five-year survival does not exceed 20% after radical surgery, the best available treatment. Unfortunately, only 40% of the patients are amenable to surgery because of poor general status and/or locoregional extension. Adjuvant treatment did not yield survival improvement. Preoperative radiotherapy (three randomized trials) or postoperative radiotherapy (one randomized trial) showed only a decrease of regional relapses, perhaps only for the nodes negative patients. Neoadjuvant chemotherapy obtains some interesting response rate (20-60%), but there has been no evidence yet for survival improvement. Recently, promising results were presented after combination of radiotherapy and chemotherapy. In this paper, we review the present status of combined treatment for esophageal cancer. Our multicentric group (OSOF) is now completing a phase II trial, that should soon form the basis for a phase III prospective study.
食管癌的预后非常差。根治性手术是目前最佳的治疗方法，但术后五年生存率不超过20%。不幸的是，由于一般状况较差和/或局部区域扩展，只有40%的患者适合手术。辅助治疗并未提高生存率。术前放疗（三项随机试验）或术后放疗（一项随机试验）仅显示局部复发率有所降低，可能仅适用于淋巴结阴性的患者。新辅助化疗有一定的有效率（20%-60%），但尚无证据表明能提高生存率。最近，放疗和化疗联合治疗取得了令人鼓舞的结果。在本文中，我们综述了食管癌联合治疗的现状。我们的多中心研究组（OSOF）目前正在完成一项II期试验，该试验应很快为III期前瞻性研究奠定基础。
