Gary-Bobo J, Pujol H, Solassol C, N'Guyen M, Gary-Bobo A
J Radiol Electrol Med Nucl. 1978 May;59(5):343-5.
It would appear that pre-operative radiotherapy early in the treatment of oesophageal cancer has avoided in many cases (especially those in an advanced stage), the appearance of local recurrences, which cause death very rapidly during the first year in those patients having surgical treatment only. This treatment, however, which is only localized to the mediastinum, has not prevented the appearance of metastases at a later date. It is obvious, therefore, that though we have improved local prognosis by localized and regional treatment, and the association of radiotherapy and surgery, we have not been able to act on the residual cancerous disease, and something else is needed. This "something else" must be chemotherapy, but at the present time we do not know which product, at which dose, and at which moment, this chemotherapy should be applied to be most effective.
看起来,在食管癌治疗早期进行术前放疗在很多情况下(尤其是晚期病例)避免了局部复发的出现,而对于仅接受手术治疗的患者,局部复发会在第一年迅速导致死亡。然而,这种仅局限于纵隔的治疗方法并未能防止后期转移的出现。因此,很明显,尽管我们通过局部和区域治疗以及放疗与手术的联合改善了局部预后,但我们仍无法对残留的癌性疾病采取有效措施,还需要其他手段。这个“其他手段”必须是化疗,但目前我们不知道哪种药物、多大剂量以及在哪个阶段应用化疗最为有效。