Nemoto Kenji, Yamada Shogo, Nishio Masamichi, Aoki Masahiko, Nakamura Ryuji, Matsumoto Yasuo, Sasamoto Ryuta, Saitoh Yoshihiro, Takayama Makoto, Mitsuhashi Norio, Gomi Kohtaro, Kanesaka Naoto, Kobayashi Masao, Ohnishi Hiroshi, Sasaki Shigeru, Tamamura Hiroyasu, Mitsumori Michihide, Nishimura Yasumasa, Tsujino Kayoko, Takemoto Mitsuhiro, Uchida Nobue, Yamamoto Michinori, Shioyama Yoshiyuki, Hirakawa Kohichi, Ono Seiji
Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aobaku, Sendai 980-8574, Japan.
Anticancer Res. 2006 Mar-Apr;26(2B):1507-12.
Superficial esophageal cancer (SEC) is defined as esophageal cancer limited to the submucosal layers, including mucosal cancer and submucosal cancer, and is squamous cell carcinoma in most patients. In 2000, the Japanese Society of Therapeutic Radiology and Oncology (JASTRO) Study Group for SEC published a consensus guideline of standard radiotherapy methods. In this study, the interim treatment outcomes of SEC patients, who had received radiation therapy following the standard radiotherapy methods, were investigated.
From 2000 to 2003, a total of 141 SEC patients were treated in 24 institutions in Japan.
The 1-, 2- and 3-year survival rates were 95%, 90% and 90%, respectively, for patients with mucosal cancer and 90%, 81% and 70%, respectively, for patients with submucosal cancer. The overall survival was better in patients who had undergone chemotherapy than in patients who had received radiation therapy alone, though the difference was not statistically significant. The clinical target volume (CTV) did not influence overall survival and intracavitary irradiation did not influence the local control rate in either patients with mucosal or submucosal cancer. Radiation-induced esophageal ulcer was not observed in this series.
The standard radiotherapy methods are safe and effective for treating SEC. However, the usefulness of chemotherapy and intracavitary irradiation and the optimal setting of the CTV should be clarified by future randomized trials.
浅表性食管癌（SEC）被定义为局限于黏膜下层的食管癌，包括黏膜癌和黏膜下癌，且大多数患者为鳞状细胞癌。2000年，日本放射治疗与肿瘤学会（JASTRO）浅表性食管癌研究组发布了标准放疗方法的共识指南。在本研究中，对按照标准放疗方法接受放射治疗的SEC患者的中期治疗结果进行了调查。
2000年至2003年期间，日本24家机构共治疗了141例SEC患者。
黏膜癌患者的1年、2年和3年生存率分别为95%、90%和90%，黏膜下癌患者的相应生存率分别为90%、81%和70%。接受化疗的患者总体生存率优于单纯接受放射治疗的患者，尽管差异无统计学意义。临床靶体积（CTV）不影响总体生存率，腔内照射对黏膜癌或黏膜下癌患者的局部控制率均无影响。本系列中未观察到放射性食管炎。
标准放疗方法治疗SEC安全有效。然而，化疗和腔内照射的有效性以及CTV的最佳设置应通过未来的随机试验加以明确。
