食管癌患者先行诱导放化疗，然后进行食管切除术。

Induction chemoradiotherapy followed by esophagectomy in patients with carcinoma of the esophagus.

作者信息

Jones D R, Detterbeck F C, Egan T M, Parker L A, Bernard S A, Tepper J E

机构信息

Multidisciplinary Thoracic Oncology Program, University of North Carolina, Chapel Hill 27599-7065, USA.

出版信息

Ann Thorac Surg. 1997 Jul;64(1):185-91; discussion 191-2. doi: 10.1016/s0003-4975(97)00449-9.

DOI:10.1016/s0003-4975(97)00449-9

PMID:9236358

Abstract

BACKGROUND

Induction chemoradiotherapy followed by esophagectomy may provide results superior to those of single-modality treatment in patients with esophageal cancer. The purpose of this study was to review our experience with this approach for esophageal cancer.

METHODS

From 1988 to 1996, 166 consecutive patients with esophageal cancer were evaluated; 66 entered a protocol of chemotherapy (5-fluorouracil, cisplatin) concurrent with radiation (45 Gy) followed by esophagectomy. Fifty-four patients completed the protocol.

RESULTS

Toxicity associated with induction chemoradiotherapy was minimal. The actuarial survival at 12, 24, and 36 months was 59%, 42%, and 32%, respectively. The pathologic complete response (pCR) rate was 41%, with 12-, 24-, and 36-month survivals of 77%, 50%, and 45%, whereas non-pCR patients had survivals of 46%, 35%, and 23%. The difference in survival between pCR and non-pCR patients was not significant (p = 0.13), but the difference in recurrence-free survival was significant (p = 0.007).

CONCLUSIONS

This well-tolerated protocol resulted in a high pCR. Trimodality treatment for esophageal cancer may provide long-term survival in some patients regardless of their pCR status.

摘要

背景

对于食管癌患者，诱导化疗放疗后行食管切除术可能比单一治疗方式效果更佳。本研究旨在回顾我们采用这种方法治疗食管癌的经验。

方法

1988年至1996年，对166例连续的食管癌患者进行评估；66例患者进入化疗（5-氟尿嘧啶、顺铂）联合放疗（45 Gy）方案，随后行食管切除术。54例患者完成了该方案。

结果

诱导化疗放疗相关的毒性极小。12个月、24个月和36个月的精算生存率分别为59%、42%和32%。病理完全缓解（pCR）率为41%，12个月、24个月和36个月的生存率分别为77%、50%和45%，而非pCR患者的生存率为46%、35%和23%。pCR患者和非pCR患者的生存差异不显著（p = 0.13），但无复发生存差异显著（p = 0.007）。