| 摘要 |
Background and purpose: The result of surgical resection alone for patients with
locally advanced esophageal cancer had been unsatisfactory before in our hospital. A treatment protocol was started in 1995 to test the effect of preoperative concurrent chemoradiation (CCRT) followed by surgery on patient survival, compared with surgery alone.
Methods: Patients with locally advanced esophageal carcinoma (≥T2 or N1) received preoperative concurrent CCRT, which included daily cisplatin (6 mg/m2/day) plus flurouracil (5-Fu) (225 mg/m2/day) with concurrent radiation at a daily fraction dosage of 200 cGy, 5 days per week, for a total dose of 3,600 cGy. Surgical resection was performed 3 to 4 weeks after CCRT.
Results: During the period from January 1987 through December 1999, a total of
169 patients with esophageal carcinoma were treated in our department. Sixtyseven patients had received complete course of preoperative CCRT. After CCRT, tumor response rate was 55.3% (partial response, 29.9% and complete response, 25.4%). After surgery, the in-hospital operative mortality was 20.9% in CCRT plus surgery group, which was slightly higher than surgery alone group (13.7%), but the difference was statistically insignificant. CCRT plus surgery group had a better 5-year survival rate (52.3%) than surgery alone group (19.5%). In this series, tumor size, pathological stage, status of lymph node metastasis and tumor response to CCRT are significant prognostic factors.
Conclusions: Utilization of preoperative CCRT followed by surgical resection for
locally advanced esophageal cancer provides a better patient survival compared
with surgery alone. |
