Bosset J F, Gignoux M, Mantion G, Heyd B, Salame E, Queneau P E, Lorchel F
Services de Cancerologie, Chirurgie, Gastroentérologie, CHU Jean-Minjoz, Besançon.
Ann Chir. 1998;52(2):185-91.
Concomitant radiochemotherapy has totally changed the treatment of oesophagus cancer. After numerous phase II studies that indicated their feasibility and efficacy, randomised phase III studies recently demonstrated their ability to improve survival. In operable cancer, preoperative radiochemotherapy increases the overall survival in adenocarcinoma, and the disease-free survival in squamous cell cancers, in comparison to surgery alone. In locally advanced disease, radiochemotherapy is considered as standard treatment. At this moment the effective drugs are 5-fluorouracil, mitomycin C and cisplatinum. The aims of current studies are to increase further the therapeutic ratio, the ways being refinements of radiotherapy and new chemotherapy delivery modalities. Finally the efficacy of radio-chemotherapy is questionning the role of surgery in this disease.
同步放化疗彻底改变了食管癌的治疗方式。在众多表明其可行性和疗效的II期研究之后，近期的随机III期研究证实了其改善生存的能力。在可手术切除的癌症中，与单纯手术相比，术前同步放化疗可提高腺癌的总生存率以及鳞状细胞癌的无病生存率。在局部晚期疾病中，同步放化疗被视为标准治疗。目前有效的药物有5-氟尿嘧啶、丝裂霉素C和顺铂。当前研究的目标是进一步提高治疗比率，方法是优化放疗和采用新的化疗给药方式。最后，放化疗的疗效对手术在这种疾病中的作用提出了质疑。
