Ajani Jaffer, D'Amico Thomas A, Hayman James A, Meropol Neal J, Minsky Bruce
University of Texas M. D. Anderson Cancer Center, USA.
J Natl Compr Canc Netw. 2003 Jan;1(1):14-27. doi: 10.6004/jnccn.2003.0004.
Esophageal cancer is a major health hazard in many parts of the world. The incidence of adenocarcinoma is rising in white men, particularly in the nonendemic areas, such as the West. Barrett's metaplasia, gastroesophageal reflux, hiatal hernia, and obesity are thought to play a role in these cases. In addition, the most common location of esophageal carcinoma has shifted to the lower third of the esophagus. Unfortunately, esophageal carcinoma is often diagnosed late; therefore, most therapeutic approaches are palliative. Advances have been made in staging procedures and in therapeutic approaches. The NCCN Esophageal Cancer Guidelines emphasize that palpable advances have been made in the treatment of locoregional esophageal carcinoma. Similarly, endoscopic palliation of esophageal carcinoma has improved substantially due to improving technology. A number of new chemotherapeutic agents are on the horizon including antireceptor agents, vaccines, gene therapy, and antiangiogenic agents. The panel expects numerous advances in the treatment of esophageal carcinoma in the future.
食管癌是世界上许多地区的主要健康威胁。在白人男性中，腺癌的发病率正在上升，尤其是在非高发地区，如西方。巴雷特化生、胃食管反流、食管裂孔疝和肥胖被认为在这些病例中起作用。此外，食管癌最常见的发病部位已转移至食管下三分之一处。不幸的是，食管癌往往在晚期才被诊断出来；因此，大多数治疗方法都是姑息性的。在分期程序和治疗方法方面已经取得了进展。美国国立综合癌症网络（NCCN）食管癌指南强调，在局部区域食管癌的治疗方面已经取得了明显进展。同样，由于技术的改进，食管癌的内镜姑息治疗也有了显著改善。一些新的化疗药物即将问世，包括抗受体药物、疫苗、基因治疗和抗血管生成药物。该小组预计未来食管癌的治疗将取得众多进展。
