Junginger T, Gockel I, Gönner U, Schmidberger H
Universitätsmedizin Mainz, Klinik für Allgemein- und Abdominalchirurgie Mainz, Deutschland.
Zentralbl Chir. 2010 Dec;135(6):541-6. doi: 10.1055/s-0030-1262693. Epub 2010 Dec 13.
Palliative therapy for patients with incurable oesophageal cancer necessitates a broad spectrum of different measures to relieve symptoms.
Surgical procedures (palliative tumour resections, bypass surgery) are rarely indicated on account of the high morbidity. Preeminent treatment options to eliminate dysphagia and to ensure food passage are endoscopic procedures, in particular, the endoscopically or radiologically guided stent implantation. In case of failure, a percutaneous feeding tube and general palliative measures are required. Furthermore tumour-specific therapies (brachytherapy, radiochemotherapy, chemotherapy) are applied.
The choice of the procedure is based on the symptoms, the tumour situation, the patients' general status, and their preferences. If possible, an individual, interdisciplinary treatment concept for each patient should be designed and modified according to the course of the disease.
It should be the aim of future studies to elucidate the optimal combination of a merely symptomatic treatment with tumour-specific measures under the aspect of the achievable quality of life.
对于无法治愈的食管癌患者，姑息治疗需要采取广泛的不同措施来缓解症状。
由于高发病率，手术程序（姑息性肿瘤切除术、旁路手术）很少被采用。消除吞咽困难并确保食物通过的主要治疗选择是内镜手术，特别是内镜或放射引导下的支架植入。如果失败，则需要经皮喂食管和一般姑息措施。此外，还应用肿瘤特异性疗法（近距离放射疗法、放化疗、化疗）。
手术方式的选择基于症状、肿瘤情况、患者的一般状况及其偏好。如果可能，应为每位患者设计个性化的多学科治疗方案，并根据疾病进程进行调整。
未来研究的目标应该是在可实现的生活质量方面，阐明单纯对症治疗与肿瘤特异性措施的最佳组合。
