Siersema P D, Dees J, van Blankenstein M
Dept. of Gastroenterology and Hepatology (Internal Medicine II), University Hospital Rotterdam-Dijkzigt, The Netherlands.
Scand J Gastroenterol Suppl. 1998;225:75-84. doi: 10.1080/003655298750027272.
Palliative therapies for advanced oesophageal cancer include surgery, radiation therapy, chemotherapy, endoscopic procedures and combinations of these. Of the non-endoscopic modalities is external beam radiation therapy (EBRT) effective and non-invasive. A disadvantage is that relief of dysphagia only occurs over a period of 4-6 weeks. Brachytherapy is more rapid in locally controlling tumour growth and in relieving dysphagia. One of the more commonly used endoscopic procedures is laser therapy, which provides symptomatic relief with low complication rates. Recurrent dysphagia is a problem necessitating repeated treatment sessions. Self-expanding metal stents offer a high degree of palliation and are associated with fewer complications compared with prosthetic tubes. Longer palliation and perhaps even longer survival might be achieved by the combination of different therapies. Most promising are the combination of EBRT plus brachytherapy or chemoradiation. Now is the time to determine which treatment (combination) is best for individual patients.
晚期食管癌的姑息治疗方法包括手术、放射治疗、化疗、内镜治疗以及这些方法的联合应用。在非内镜治疗方式中，外照射放疗（EBRT）有效且无创。其缺点是吞咽困难的缓解仅在4至6周的时间内出现。近距离放射治疗在局部控制肿瘤生长和缓解吞咽困难方面更为迅速。较为常用的内镜治疗方法之一是激光治疗，它能缓解症状且并发症发生率低。复发性吞咽困难是一个问题，需要重复治疗。自膨式金属支架提供了高度的姑息治疗效果，与假体管相比并发症更少。不同治疗方法联合应用可能实现更长时间的姑息治疗，甚至可能延长生存期。最有前景的是EBRT联合近距离放射治疗或放化疗。现在是确定哪种治疗（联合治疗）对个体患者最佳的时候了。
