University Cancer Center Leipzig (UCCL), University Clinic Leipzig, Liebigstraße 20, Leipzig, Germany.
Langenbecks Arch Surg. 2013 Feb;398(2):177-87. doi: 10.1007/s00423-012-1001-1. Epub 2012 Sep 13.
The treatment of localized esophageal cancer has been debated controversially over the past decades. Neoadjuvant treatment was used empirically, but evidence was limited due to the lack of high-quality confirmatory studies. Meanwhile, data have become much clearer due to recently published well-conducted randomized controlled trials and meta-analyses.
Neoadjuvant and perioperative platinum fluoropyrimidine-based combination chemotherapy has now an established role in the treatment of stage II and stage III esophageal adenocarcinoma and cancer of the esophago-gastric junction. Neoadjuvant chemoradiation is now the standard of care for treating stage II and stage III esophageal squamous cell cancer and can also be considered for treating esophageal adenocarcinoma.
Patients with esophageal squamous cell cancer treated with definitive chemoradiation achieve comparable long-term survival compared with surgery. Short-term mortality is less with chemoradiation alone, but local tumor control is significantly better with surgery.
This expert review article outlines current data and literature and delineates recommendable treatment guidelines for localized esophageal cancer.
在过去几十年中，局部食管癌的治疗一直存在争议。新辅助治疗是经验性的，但由于缺乏高质量的确认性研究，证据有限。与此同时，由于最近发表的精心设计的随机对照试验和荟萃分析，数据变得更加清晰。
新辅助和围手术期铂类氟嘧啶联合化疗现在在治疗 II 期和 III 期食管腺癌和食管胃交界部癌中具有确定的作用。新辅助放化疗现在是治疗 II 期和 III 期食管鳞癌的标准治疗方法，也可以考虑用于治疗腺癌。
接受根治性放化疗的食管鳞癌患者的长期生存与手术相当。单纯放化疗的短期死亡率较低，但手术的局部肿瘤控制明显更好。
本文综述了目前的研究数据和文献，并为局部食管癌制定了推荐的治疗指南。
