Bains M S, Kelsen D P, Beattie E J, Martini N
Ann Thorac Surg. 1982 Nov;34(5):521-8. doi: 10.1016/s0003-4975(10)62998-0.
Thirty-four patients with epidermoid carcinoma of the esophagus received a triple-drug regimen preoperatively consisting of cisplatin, vindesine, and bleomycin. Partial response to chemotherapy (greater than 50% reduction in measurable tumor size with concomitant improvement in swallowing function) was noted in 65% of the patients. Of the 34 patients, 28 (82%) had resectable disease. A one-stage high esophagogastrectomy utilizing the end-to-end anastomosis stapling device was performed on all 28 patients. Operation was followed by external radiation therapy to the esophageal bed, to a tumor dose of 5,500 rads delivered in 5 weeks. The postoperative median follow-up is now 14 months (range, 7 to 36 months). Thirteen patients are alive and well, and 10 patients have relapsed, 4 of whom are still alive with disease. Two patients died of postoperative complications, and 1 death was drug related. On the other hand, 5 of the 6 patients with unresected tumors died within 5 months. While the preliminary results are encouraging, longer follow-up will be required to determine whether the response rate to chemotherapy will result in a longer disease-free interval and longer survival.
34例食管鳞状细胞癌患者术前接受了由顺铂、长春地辛和博来霉素组成的三联药物治疗方案。65%的患者对化疗有部分反应（可测量肿瘤大小减少超过50%，同时吞咽功能改善）。34例患者中，28例（82%）有可切除疾病。所有28例患者均采用端端吻合器进行一期高位食管胃切除术。术后对食管床进行外照射，5周内给予肿瘤剂量5500拉德。术后中位随访时间为14个月（范围7至36个月）。13例患者存活且情况良好，10例患者复发，其中4例仍带瘤存活。2例患者死于术后并发症，1例死亡与药物有关。另一方面，6例未切除肿瘤的患者中有5例在5个月内死亡。虽然初步结果令人鼓舞，但需要更长时间的随访来确定化疗反应率是否会导致更长的无病间期和更长的生存期。
