食管癌术后辅助治疗的临床价值

食管癌目前主要的治疗手段仍为手术切除,但术后患者的生存率较低,主要失败模式为局部复发和区域淋巴结转移.术后是否应该行辅助治疗及如何选择方案仍无明确的指南.研究显示Ⅲ期、N1的患者行术后辅助放疗可以提高无瘤生存率及总生存率,靶区范围应根据肿瘤所在的位置来确定.术后辅助化疗方案以顺铂联合5-氟尿嘧啶为首选,该方案主要不良反应为胃肠反应和骨髓抑制;术后辅助放化疗的临床价值仍需更多临床研究来支持.

Clinical value of adjuvant therapy for esophageal cancer after radical resection

Surgery is the standard therapy for esophageal cancer, however, the postoperative overall survival rate is still disappointed. Local recurrence and regional lymph node metastasis are the main failure models. The optimal therapeutic modality for these patients with radical resection remains unclear. Some researches indicate that patients with stage Ⅲ, N1 can benefit from postoperative radiotherapy, which can improve the disease free survival and overall survival ratio. The irradiation field depends on the site of tumor removal (tumor bed) during surgery. The cisplatin plus 5 fluorouracil chemotherapy regimen seems as the preferred for postoperative adjuvant chemotherapy, the mainly adverse reactions are digestive tract reactions and myelosuppression. The clinical value of postoperative adjuvant chemoradiotherapy still needs more clinical trials to support.