Kelsen D P, Hilaris B, Martini N
Department of Medicine, Memorial Sloan-Kettering Cancer Center, Cornell University Medical College, New York.
Semin Surg Oncol. 1986;2(3):170-6. doi: 10.1002/ssu.2980020310.
Neoadjuvant, or preoperative, chemotherapy for esophageal cancer has become an area of increasing interest because of the failure of conventional therapy (surgery or radiation) to improve disease-free or overall survival. Several autopsy series have demonstrated that, in many symptomatic western patients, esophageal cancer is a systemic disease. Neoadjuvant chemotherapy thus, in theory, allows a simultaneous attack on both the primary and metastatic disease. A number of single-arm, phase II multimodality trials have been completed. Toxicities of chemotherapy, while substantial, have been tolerable. With careful attention to detail, operative morbidity and mortality has not been increased. Large-scale randomized trials are needed to evaluate the impact of this technique on disease-free and overall survival.
由于传统治疗方法（手术或放疗）未能提高无病生存率或总生存率，新辅助化疗（即术前化疗）已成为食管癌领域日益受关注的一个方面。多项尸检系列研究表明，在许多有症状的西方患者中，食管癌是一种全身性疾病。因此，从理论上讲，新辅助化疗可以同时对原发性疾病和转移性疾病进行治疗。一些单臂II期多模式试验已经完成。化疗的毒性虽然很大，但仍可耐受。通过对细节的密切关注，手术发病率和死亡率并未增加。需要进行大规模随机试验来评估该技术对无病生存率和总生存率的影响。
