Imdahl A
Klinikum Heidenheim, Abt. für Viszeral-, Thorax- und Gefässchirurgie.
Zentralbl Chir. 2006 Apr;131(2):105-9. doi: 10.1055/s-2006-921531.
Neoadjuvant therapy has been implemented to improve the prognosis of patients with oesophageal cancer. Operative therapy remains the therapy of choice for nonmetastatic disease in patients who can tolerate resection. Adjuvant therapy following resection is usually not indicated. For neoadjuvant therapy it seems to be confirmed that preoperative radiotherapy has only very little benefit and therefore, should not be recommended. Data for preoperative chemotherapy are conflicting. Following preoperative combined radio-chemotherapy a complete response of tumour can be expected in 20-25 % of treated patients with a marked advantage for these patients. However, there are still no markers available indicating tumour response before the start of perioperative radio-chemotherapy. Recently published meta-analyses confirm a small overall benefit for perioperative radio-chemotherapy. However, these data so far have not led to a broad agreement on the indication of neoadjuvant therapy in oesophageal cancer.
新辅助治疗已被用于改善食管癌患者的预后。手术治疗仍然是能够耐受切除的非转移性疾病患者的首选治疗方法。切除术后通常不进行辅助治疗。对于新辅助治疗，似乎已证实术前放疗获益甚微，因此不应推荐。术前化疗的数据存在矛盾。术前放化疗联合治疗后，预计20% - 25%的患者肿瘤会完全缓解，这些患者具有显著优势。然而，在围手术期放化疗开始前，仍没有可用的标志物来指示肿瘤反应。最近发表的荟萃分析证实围手术期放化疗总体获益较小。然而，迄今为止这些数据尚未就食管癌新辅助治疗的适应证达成广泛共识。
