Taal B G, Aleman B M, Lebesque J V, Steinmetz R
Department of Medical Oncology, Netherlands Cancer Institute (NKI), Amsterdam.
Eur J Cancer. 1993;29A(8):1114-9. doi: 10.1016/s0959-8049(05)80299-0.
16 patients, presenting with squamous cell carcinoma in previously irradiated sections of the oesophagus, are described. Oesophagectomy could be performed in 2 patients, resulting in long-term disease-free survival (38 and 60 months after diagnosis). 14 patients were treated with palliative radiotherapy (external beam or intraluminal), oesophageal stenting, bougienage or chemotherapy. Although most patients previously received curative dosages of mediastinal irradiation, additional full courses of high-dose radiotherapy could be given on five occasions; no major complications were encountered and adequate palliation for up to 10 months was achieved. Similar results were observed after oesophageal stenting and/or bougienage. Relief of dysphagia following intraluminal radiotherapy or chemotherapy was only minimal (2 months or less). Median survival in the palliative treatment group was 6.5 months (range 2-27 months), which is in keeping with results observed in non-radiation-associated oesophageal carcinoma. We concluded that, in selected cases, both surgery and radiotherapy offer good prospects for patients with radiation-associated oesophageal cancer.
本文描述了16例在先前接受过放疗的食管节段出现鳞状细胞癌的患者。2例患者可行食管切除术，实现了长期无病生存（诊断后38个月和60个月）。14例患者接受了姑息性放疗（外照射或腔内照射）、食管支架置入术、探条扩张术或化疗。尽管大多数患者先前接受了根治剂量的纵隔放疗，但有5次给予了额外的全疗程高剂量放疗；未出现重大并发症，实现了长达10个月的充分姑息治疗。食管支架置入术和/或探条扩张术后也观察到了类似结果。腔内放疗或化疗后吞咽困难的缓解程度极小（2个月或更短时间）。姑息治疗组的中位生存期为6.5个月（范围2 - 27个月），这与非放疗相关食管癌的观察结果一致。我们得出结论，在特定病例中，手术和放疗对放疗相关食管癌患者都提供了良好的前景。
