Department of General, Visceral and Cancer Surgery, University of Cologne, Kerpener Str. 62, 50937 Köln, Germany.
Future Oncol. 2010 Jan;6(1):25-35. doi: 10.2217/fon.09.133.
A review of the literature demonstrated that clinical evaluation cannot be used to determine 'complete response'. The different classification systems of the histopathologic response grading after neoadjuvant radiochemotherapy of esophageal carcinoma are summarized in this report. A systematic review of studies analyzing preoperative chemoradiation of squamous cell carcinoma (SCC) or adenocarcinoma (AC) of the esophagus demonstrated no significant difference in pathologic complete response (pCR) rates between the AC and SCC studies. Analyzing only the applied dose of radiation demonstrated that patients with AC required a higher dose than patients with SCC to achieve complete response. Incorporating chemotherapy administration does not markedly change the difference in required radiation dose. However, when the tumor does respond, the rate of pCR with increasing dosage of chemoradiotherapy increases more rapidly in AC patients than in SCC patients.
文献回顾表明，临床评估不能用于确定“完全缓解”。本报告总结了食管癌新辅助放化疗后组织病理学反应分级的不同分类系统。系统回顾分析术前放化疗治疗食管鳞癌（SCC）或腺癌（AC）的研究表明，AC 和 SCC 研究之间病理完全缓解（pCR）率无显著差异。仅分析放射剂量显示，AC 患者需要比 SCC 患者更高的剂量才能达到完全缓解。加入化疗给药并不会显著改变所需放射剂量的差异。然而，当肿瘤发生反应时，随着放化疗剂量的增加，AC 患者的 pCR 率增加得更快，而 SCC 患者则较慢。
