Hancock S L, Goffinet D R, Carlson R W, Mark J B
Radiology. 1987 Sep;164(3):603-6. doi: 10.1148/radiology.164.3.3112863.
Between 1969 and 1986, 109 consecutive patients with esophageal carcinoma were studied. Of the 77 patients who had squamous cell carcinoma, 62 received definitive treatment for disease confined to the esophagus and regional nodes. Survival was equivalent whether they were treated with radiation alone (n = 18), preoperative radiation and esophagectomy (n = 19), postoperative radiation (n = 5), or a combination of chemotherapy and radiation with or without esophagectomy (n = 20). Fifteen patients had significantly poorer survival after palliative irradiation for overt metastatic disease or severe debility. The pathologic specimens from four of the nine patients who underwent resection showed no histologic evidence of residual tumor; however, tumor recurred in three in the mediastinum, and only one remains alive and free of disease. Four of the 11 patients who received chemotherapy and radiation therapy without resection remain alive and free of disease after further mediastinal irradiation, suggesting a benefit from additional regional therapy. Chemotherapy improved median survival duration and complete response rate but did not produce a significant improvement in survival, as reported in other recent series.
1969年至1986年间，对109例连续性食管癌患者进行了研究。在77例鳞状细胞癌患者中，62例接受了针对局限于食管及区域淋巴结疾病的确定性治疗。无论单独接受放疗（n = 18）、术前放疗加食管切除术（n = 19）、术后放疗（n = 5），还是化疗与放疗联合（有或无食管切除术，n = 20），其生存率相当。15例患者因明显转移性疾病或严重虚弱接受姑息性放疗后，生存率显著较差。接受切除的9例患者中，有4例的病理标本未显示残留肿瘤的组织学证据；然而，3例患者肿瘤在纵隔复发，仅1例仍存活且无疾病。11例未接受切除而接受化疗和放疗的患者中，4例在进一步纵隔放疗后仍存活且无疾病，提示额外区域治疗有益。化疗改善了中位生存时间和完全缓解率，但未显著提高生存率，正如其他近期系列报道的那样。
