Pearson J G
Cancer. 1977 Feb;39(2 Suppl):882-90. doi: 10.1002/1097-0142(197702)39:2+<882::aid-cncr2820390726>3.0.co;2-x.
The management of 2032 patients with squamous esophageal cancer seen in Edinburgh from 1931 to 1969 was studied. Since 1949 more radical surgical treatment has been offered and since 1956 more radical radiotherapy. From 1949 to 1969 there has been a swing over from mainly surgical to mainly radiation treatment associated with a rise in the overall one and five-year survival rates to 32% and 9% respectively. The main reason for failure is the prevalence of disseminated disease. The significant mortality of surgical treatment limits its usefulness. Too often, radiotherapy fails because of recurrence of tumor within the irradiated volume. In the upper 2/3 of the esophagus irradiation is preferable to surgery because of better sirvoval. In the lower 1/3 the two methods achieve similar long term survival but following irradiation the short term survival is better and the patient retains a normal stomach. Improvement could be achieved by prevention, earlier diagnosis, improved tumor delineation and a wide range of measures to improve the local effectiveness of irradiation.
对1931年至1969年在爱丁堡就诊的2032例食管鳞状癌患者的治疗情况进行了研究。自1949年起提供了更根治性的手术治疗，自1956年起提供了更根治性的放射治疗。从1949年到1969年，治疗方式已从主要采用手术转变为主要采用放射治疗，总体一年和五年生存率分别提高到32%和9%。治疗失败的主要原因是存在播散性疾病。手术治疗的显著死亡率限制了其效用。放射治疗常常因照射野内肿瘤复发而失败。在食管上2/3段，由于生存率更高，放射治疗优于手术治疗。在食管下1/3段，两种方法的长期生存率相似，但放射治疗后的短期生存率更高，且患者保留正常胃。可通过预防、早期诊断、改善肿瘤定位以及一系列提高放射治疗局部效果的措施来实现改善。
