Noordman B J, Wijnhoven B P L, Lagarde S M, Spaander M C W, Valkema R, van Lanschot J J B
*Namens de Rotterdamse Slokdarm Werkgroep.
Ned Tijdschr Geneeskd. 2017;161:D1818.
In many countries, neoadjuvant chemoradiotherapy (nCRT) plus surgery is standard treatment for resectable oesophageal cancer. After nCRT, up to 30% of all patients have no residual disease in the resection specimen. Consequently, an active surveillance approach, in which patients undergo frequent clinical investigations after nCRT instead of standard oesophagectomy, is increasingly applied in selected patients. Here, we describe outcomes for three patients who underwent active surveillance. A 63-year old woman was considered unfit for surgery after nCRT. Four years after completion of nCRT, she still had no signs of disease recurrence. The second patient, a 57-year old woman, refused surgery when no residual disease was detectable after nCRT. One year following treatment, she developed a vertebral metastasis, in the absence of locoregional disease. The third patient concerned a 66-year old man with a clinically complete response after nCRT, who also refused surgery. During active surveillance, he developed a locoregional regrowth and underwent a radical oesophagectomy.
在许多国家，新辅助放化疗（nCRT）加手术是可切除食管癌的标准治疗方法。新辅助放化疗后，高达30%的患者在切除标本中没有残留疾病。因此，一种积极监测的方法越来越多地应用于部分患者，即患者在新辅助放化疗后接受频繁的临床检查，而不是进行标准的食管切除术。在此，我们描述了三名接受积极监测患者的治疗结果。一名63岁女性在新辅助放化疗后被认为不适合手术。新辅助放化疗完成四年后，她仍没有疾病复发的迹象。第二名患者是一名57岁女性，在新辅助放化疗后未检测到残留疾病时拒绝手术。治疗一年后，她在没有局部区域疾病的情况下发生了椎体转移。第三名患者是一名66岁男性，新辅助放化疗后临床完全缓解，他也拒绝手术。在积极监测期间，他出现了局部区域复发，随后接受了根治性食管切除术。
