Ikebe M, Kuwano H, Maekawa S, Sugimachi K
Dept. of Surgery II, Faculty of Medicine, Kyushu University.
Gan To Kagaku Ryoho. 1994 Mar;21(4):425-30.
To obtain a better prognosis, multidisciplinary treatment is essential for esophageal cancer. We prescribed hyperthermia combined with irradiation and chemotherapy (HCR) preoperatively for patients with resectable esophageal squamous cell carcinoma. The local effect of the HCR therapy was better than that of chemotherapy and radiotherapy (CR), showing 19.3% of the complete response rate. The five-year survival rate of stage III and IV patients given preoperative HCR was 18.5%, compared with 10.4% in the CR therapy group and 10.5% in the preoperative no treatment group. Moreover, preoperative HCR therapy improved prognosis of cases with far advanced cancer which invades the neighboring organs, showing 20.1% of 3-year survival rate. To evaluate the effectiveness of hyperthermia more objectively, we started a prospective randomized trial from 1988, comparing HCR therapy and CR therapy. The local effect is better in HCR therapy. When treated with cisplatin, the rate of complete response (Grade 3) in HCR therapy was 35.3%, which is as high as for the multi-drug combined treatment reported from other institutes previously. More effective multidisciplinary treatment together with basic research are necessary for a better therapeutic outcome.
为获得更好的预后,多学科治疗对食管癌至关重要。我们对可切除的食管鳞状细胞癌患者术前采用热疗联合放疗及化疗(HCR)。HCR疗法的局部疗效优于化疗和放疗(CR),完全缓解率达19.3%。术前接受HCR的III期和IV期患者的五年生存率为18.5%,而CR治疗组为10.4%,术前未治疗组为10.5%。此外,术前HCR疗法改善了侵犯邻近器官的晚期癌症病例的预后,三年生存率为20.1%。为更客观地评估热疗的有效性,我们从1988年开始了一项前瞻性随机试验,比较HCR疗法和CR疗法。HCR疗法的局部疗效更好。当使用顺铂治疗时,HCR疗法的完全缓解率(3级)为35.3%,与其他机构之前报道的多药联合治疗一样高。为获得更好的治疗效果,需要更有效的多学科治疗以及基础研究。