摘要
本文评述食管癌化疗的前景与困难。全身化学治疗有可能提高食管癌患者缓解率,延长生存期和改善生活质量。联合化疗治疗食管癌有明显优越性。顺铂+氟尿嘧啶(加或不加醛氢叶酸)认为是最佳联合化疗药物,对食管鳞癌的有效率为42％-66％,对食管腺癌的有效率为27％-48％。评价较新的化疗药物,包括紫杉醇类和喜树碱类(如伊利替康)可有助于选择更为有效和较好耐受的全身治疗方案。由于单用手术或单用放疗的患者预后较差,推动食管癌的综合治疗。目前临床试验有术前(新辅助)化疗,术前同时联合化-放疗,或对局部区域病变单用化-放疗,以及对有高复发危险的患者行术后(辅助)化疗,将有助于为食管癌患者提供最佳的治疗方案。
This article reviews the prospects and difficulties of chemotherapy of esophageal cancer. Systemic chemotherapy for the patients of esophageal cancer is likely to improve remission rate and prolong survival as well as to improve quality of life. It will be noted that significant superiority of esophageal cancer is treated by combination chemotherapy. Cisplatin and 5-fluorouracil with or without leucovorin are considered the optimal chemotherapy agents in combination. Response rates are 42%-66% for squamous cell carcinoma and 27%-48% for ade-nocarcinoma. Trials evaluating newer chemotherapeutic agents, including the taxans and camptothecins (such as irinotecan) , may lead to the identification of potentially more active and better-tolerated systemic regimens. The relatively poor outcome with surgery alone or radiation alone has prompted the evaluation of combined modality therapy in esophageal cancer. Recent clinical trials have evaluated the use of preoperative (neoadjuvant) chemotherapy followed by surgery, combined concurrent preoperative chemo-radiotherapy, or definitive chemo-radiotherapy alone without surgery for loeoregional disease, and postoperative (adjuvant) chemotherapy for the patients of high risk of recurrence. This will facilitate better optimize regimens offered to patients of esophageal cancer.
出处
《癌症进展》
2004年第2期105-108,111,共5页
Oncology Progress
关键词
食管癌
化疗
综合治疗
esophageal cancer chemotherapy comprehensive therapy
