Parker E F, Gregorie H B, Prioleau W H, Marks R D, Bartles D M
Ann Surg. 1982 May;195(5):618-23. doi: 10.1097/00000658-198205000-00011.
The long-term results of treatment of primary carcinoma of the esophagus continue to be poor, and attempts to improve them remain as challenging as any that exist in the field of malignant neoplasia today. Even so, there has been improvement, and this report contrasts age, race, sex, levels of involvement, methods of treatment, and results in our first series of 170 cases, seen between 1940 and 1951, with those in our last series of 300 cases, seen between 1967 and 1975. In the latter group, among those treated by megavoltage radiation as the sole theoretically curative method, the five-year survival rate was 1.0%. Among operable patients, there were 15 who had resection without preliminary radiation, with a mortality rate of 40% (6/15), a two-year survival rate of 13% (2/15), and a five-year survival rate of 7.0% (1/15). Also among operable patients, there were 75 who had resection following radiation therapy with a mortality rate of 19% (14/75), a two-year survival rate of 20% (15/75), and a five-year survival rate of 10% (7/75). These rates contrast with a five-year survival rate of 0.5% in the 1940-1951 series. Improvements in methods of treatment and adjuncts, such as nutrition, radiation, and operation, are cited. Even so, results in our last group did not show improvement over those in the 1962-1967 series. Therefore, we have begun a new program involving the use of chemotherapy in conjunction with radiation therapy and resection in those cases in which it may be applicable.
食管癌原发性癌的长期治疗效果仍然很差，目前在恶性肿瘤领域，试图改善这些效果依然面临着巨大挑战。即便如此，还是取得了一些进展。本报告对比了1940年至1951年间我们收治的首批170例患者与1967年至1975年间收治的最后一批300例患者在年龄、种族、性别、病变部位、治疗方法及治疗结果等方面的差异。在后一组中，那些仅接受兆伏级放疗作为唯一理论上可治愈方法的患者，其五年生存率为1.0%。在可手术治疗的患者中，有15例未进行术前放疗就接受了切除术，死亡率为40%（6/15），两年生存率为13%（2/15），五年生存率为7.0%（1/15）。同样在可手术治疗的患者中，有75例在放疗后接受了切除术，死亡率为19%（14/75），两年生存率为20%（15/75），五年生存率为10%（7/75）。这些数据与1940 - 1951年系列中的五年生存率0.5%形成了对比。文中列举了治疗方法及辅助手段（如营养、放疗和手术）的改进。即便如此，我们最后一组患者的治疗结果相较于1962 - 1967年系列并未有所改善。因此，我们已经启动了一个新项目，对于可能适用的病例，采用化疗联合放疗及切除术进行治疗。
