Combined treatment for locally advanced esophageal cancer
- VernacularTitle:局部中晚期食管癌的多学科整合治疗
- Author:
Jiade LU
- Publication Type:Journal Article
- Keywords:
esophageal cancer;
adjuvant therapy;
radiotherapy;
combination therapy
- From:
China Oncology
2001;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Surgery remains the mainstay treatment modality for localized esophageal cancer;however,only 30% to 40% of patients are surgically resectable at the time of diagnosis.In addition,the long-term survival for patients with locally advanced esophageal cancer after complete resection is less than 20%.Although radiation is an effective treatment modality for localized esophageal cancer,the prognosis of patients after definitive radiotherapy is dismal.Chemoradiation therapy in combination with surgery can significantly improve the treatment outcome for patients with locally advanced esophageal cancer,and currently the multidisciplinary approach is considered the standard treatment strategy.This review summarizes the recently published literature,especially randomized clinical trials and meta-analyses on the treatment of esophageal cancer,and provides the following recommendation based on the results of scientific evidences:surgery alone should be considered as the standard treatment for clinical stage I and stage Ⅱ except for cervical esophageal cancer.For thoracic esophageal cancer,neoadjuvant chemoradiotherapy followed by complete resection should be considered for resectable locally advanced diseases.For medically inoperable and unresectable esophageal cancer,concurrent chemoradiation therapy should be considered as the standard treatment modality.For patients who were surgically treated without neoadjuvant therapy,the addition of definitive chemoradiotherapy to the definitive dose should be provided.