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[胸段食管癌的多模态管理]

[Multimodality management of squamous cell carcinoma of thoracic esophagus].

作者信息

Wang Zhe-xin, Mao Teng, Guo Xu-feng, Fang Wen-tao

机构信息

Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai 200030, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Sep;16(9):815-8.

Abstract

Most patients with esophageal cancer have advanced disease at presentation. The efficacy of surgical resection alone is often unsatisfactory in patients with stage III or more advanced cancer according to the seventh edition of UICC staging system for esophageal cancer. The systematic multidisciplinary treatment is important. Mounting evidence indicates that preoperative concurrent chemoradiotherapy is the most effective induction therapy to down-stage tumor and increase radical resection rate. For the esophageal squamous cell carcinoma patients with multi-stations and multi-fields lymph node metastasis, preoperative induction chemotherapy would be a viable option. For locally advanced cancers which have been surgically resected, postoperative adjuvant radiotherapy maybe helpful to improve local control for the insufficient surgical dissection. The role of adjuvant chemotherapy also needs further studies. Thoracic esophageal squamous cell carcinoma and lower esophageal adenocarcinoma which is common in western countries are different. We need more prospective clinical studies to establish our treatment modalities for esophageal cancer.

摘要

大多数食管癌患者在初诊时已处于疾病晚期。根据国际抗癌联盟(UICC)食管癌分期系统第七版,对于Ⅲ期或更晚期癌症患者,单纯手术切除的疗效往往不尽人意。系统的多学科治疗很重要。越来越多的证据表明,术前同步放化疗是使肿瘤降期并提高根治性切除率最有效的诱导治疗方法。对于有多站多野淋巴结转移的食管鳞状细胞癌患者,术前诱导化疗可能是一种可行的选择。对于已接受手术切除的局部晚期癌症,术后辅助放疗可能有助于改善因手术切除不充分导致的局部控制情况。辅助化疗的作用也需要进一步研究。胸段食管鳞状细胞癌与西方国家常见的下段食管腺癌有所不同。我们需要更多前瞻性临床研究来确立我国食管癌的治疗模式。

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