Wille Kai, Mann Carolina, Berlth Felix, Fetzner Ulrich Klaus, Othmann Katharina, Mönig Stefan Paul
Universitätsklinik für Hämatologie, Onkologie, Hämostaseologie und Palliativmedizin, Johannes Wesling Klinikum Minden, Universitätsklinikum der Ruhr-Universität Bochum, Minden, Deutschland.
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Deutschland.
Ther Umsch. 2022 Apr;79(3-4):189-194. doi: 10.1024/0040-5930/a001347.
Chemotherapy and Radio-Chemotherapy of Locally Advanced Esophageal Cancer Surgical resection alone of locally advanced esophageal carcinoma leads to long-term survival in only about 30% of cases. The multimodal strategy for locally advanced tumors, especially neoadjuvant radiochemotherapy and chemotherapy, has significantly improved the long-term prognosis. Multimodal therapy concepts have been developed which improve overall survival. Therapy planning must be performed pretherapeutically in an interdisciplinary tumor board, preferably at a high-volume center. For squamous cell carcinomas, neoadjuvant radio/chemotherapy followed by resection or definitive radio/chemotherapy are currently the therapies of choice. For adenocarcinomas, neoadjuvant radio/chemotherapy followed by resection or perioperative chemotherapy are considered equivalent therapeutic standards. After neoadjuvant radiochemotherapy, adjuvant immunotherapy is currently recommended in case of only incomplete histopathological response.
局部晚期食管癌的化疗与放化疗 仅通过手术切除局部晚期食管癌,只有约30%的病例能实现长期生存。针对局部晚期肿瘤的多模式治疗策略,尤其是新辅助放化疗和化疗,显著改善了长期预后。已经制定了多模式治疗方案以提高总生存率。治疗方案必须在治疗前由跨学科肿瘤委员会制定,最好是在大型医疗中心。对于鳞状细胞癌,目前的首选治疗方法是新辅助放化疗后进行手术切除或根治性放化疗。对于腺癌,新辅助放化疗后进行手术切除或围手术期化疗被视为等效的治疗标准。新辅助放化疗后,若组织病理学反应不完全,目前推荐进行辅助免疫治疗。