Hernández Lizoain J L, Cienfuegos J A, Pardo F, Martínez Regueira F, Sola I, Aristu J, Azinovic I
Department of General Surgery, Clínica Universitaria, School of Medicine, University of Navarra, Pamplona, Spain.
Rev Esp Enferm Dig. 1998 Apr;90(4):275-90.
The aim of this study is to assess the effect of concomitant preoperative radio-chemotherapy in the treatment of epidermoid esophageal cancer. We studied a total of 45 patients, divided into two groups. Group I consisted of 20 patients diagnosed with epidermoid esophageal cancer who had been treated initially with esophagectomy. Group II consisted of 25 patients treated with preoperative radiotherapy and two cycles of chemotherapy (cisplatin and 5-fluorouracil), one at the beginning and the other at the end of the radiation treatment, on whom an esophagectomy was subsequently performed. The clinical characteristics were similar in both groups. In group II, there were 12 cases (48%) with absence of tumor in the esophageal wall, three of which had node involvement. The operative mortality was similar in both groups (10% and 8% respectively). The only significant difference found in the postoperative complications was the incidence of anastomotic leak; but this was related to the different esophagectomy techniques used rather than the type of therapy. A decrease in the number of patients with tumor recurrence was observed in Group II, especially where the local component was concerned. The best actuarial survival rate at five years was in patients with no presence of tumor after neoadjuvant treatment (44.4%). However, the radio-chemotherapy seems not to have had any benefit in cases with node involvement.
本研究的目的是评估术前同步放化疗在治疗表皮样食管癌中的效果。我们共研究了45例患者，分为两组。第一组由20例诊断为表皮样食管癌且最初接受食管切除术治疗的患者组成。第二组由25例接受术前放疗和两个周期化疗（顺铂和5-氟尿嘧啶）的患者组成，一个周期在放疗开始时进行，另一个周期在放疗结束时进行，随后对这些患者进行了食管切除术。两组的临床特征相似。在第二组中，有12例（48%）食管壁无肿瘤，其中3例有淋巴结受累。两组的手术死亡率相似（分别为10%和8%）。术后并发症中唯一显著的差异是吻合口漏的发生率；但这与所采用的不同食管切除技术有关，而非治疗类型。在第二组中观察到肿瘤复发患者数量减少，尤其是局部复发方面。新辅助治疗后无肿瘤患者的五年最佳精算生存率为44.4%。然而，放化疗似乎对有淋巴结受累的病例没有任何益处。
