食管鳞癌术后LR的挽救性放化疗进展

doi:10.3760/cma.j.issn.1004-4221.2017.11.022

摘要
图/表
参考文献()
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (830 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

摘要

食管鳞癌患者术后LR率较高,其挽救性治疗主要采用放疗或放化疗,放疗靶区范围、剂量以及化疗方案目前尚缺乏统一标准。患者的年龄,体力状况评分,肿瘤复发部位、范围、病灶数目和大小等,以及放疗技术、放疗剂量、化疗方案和放化疗模式等因素均可影响疗效,甚至导致再次复发。本文将围绕以上内容进行综述,以期指导临床治疗。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王玉祥
	祝淑钗

关键词 ：肿瘤复发,局部, 食管肿瘤/外科学, 食管肿瘤/放射疗法, 食管肿瘤/化学疗法

Abstract：

The rate of locoregional recurrence (LR) is high in patients with esophageal squamous cell carcinoma after surgery, and salvage treatment for LR is mainly performed with radiotherapy or radiochemotherapy. However, the target and dose of radiotherapy and chemotherapy regimen are inconsistent. Several factors may affect the effect of salvage treatment and even lead to recurrence, such as age, performance status score, recurrence site, target area, and the number and size of lesions, as well as the technology and dose of radiotherapy, chemotherapy regimen, and the pattern of radiotherapy and/or chemotherapy. The article reviews the above aspects to guide clinical treatment for these patients.

Key words： Neoplasm recurrence,local Esophageal noplasms/surgery Esophageal noplasms/radiotherapy Esophageal noplasms/chemotherapy

收稿日期: 2016-11-18

引用本文:

王玉祥,祝淑钗. 食管鳞癌术后LR的挽救性放化疗进展[J]. 中华放射肿瘤学杂志, 2017, 26(11): 1342-1346.

Wang Yuxiong,Zhu Shuchai. Progress in salvage chemoradiotherapy for postoperative locoregional recurrence of esophageal squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2017, 26(11): 1342-1346.

链接本文:

http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2017.11.022 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2017/V26/I11/1342

[1] Liu Q,Cai XW,Wu B,et al. Patterns of failure after radical surgery among patients with thoracic esophageal squamous cell carcinoma:implications for the clinical target volume design of postoperative radiotherapy[J].PLoS One,2014,9(5):e97225.DOI:10.1371/journal.pone.0097225.
[2] 王玉祥,王丽丽,杨琼,等.pT3N0M0期胸段食管鳞癌胸腹两野根治术后的复发模式[J].中华肿瘤杂志,2016,38(1):48-54.DOI:10.3760/cma.j.issn.0253-3766.2016.01.010.
Wang YX,Wang LL,Yang Q,et al. Patterns of recurrence in patients with stage pT3N0M0t horacic esophageal squamous cell carcinoma after two-field esophagectomy[J].Chin J Oncol,2016,38(1):48-54.DOI:10.3760/cma.j.issn.0253-3766.2016.01.010.
[3] Guo XF,Mao T,Gu ZT,et al. Clinical study on postoperative recurrence in patients with pN0 esophageal squamous cell carcinoma[J].J Cardiothorac Surg,2014,9:150. DOI:10.1186/s13019-014-0150-4.
[4] Chen JQ,Pan JJ,Zheng XW,et al. Number and location of positive nodes,postoperative radiotherapy,and survival after esophagectomy with three-field lymph node dissection for thoracic esophageal squamous cell carcinoma[J].Int J Radiat Oncol Biol Phys,2012,82(1):475-482. DOI:10.1016/j.ijrobp.2010.08.037.
[5] Cai WJ,Xin PL.Pattern of relapse in surgical treated patients with thoracic esophageal squamous cell carcinoma and its possible impact on target delineation for postoperative radiotherapy[J].Radiother Oncol,2010,96(1):104-107. DOI:10.1016/j.radonc.2010.04.029.
[6] Li CL,Zhang FL,Wang YD,et al. Characteristics of recurrence after radical esophagectomy with two-field lymph node dissection for thoracic esophageal cancer[J].Oncol Lett,2012,5(1):355-359.DOI:10.3892/ol.2012.946.
[7] Shioyama Y,Nakamura K,Ohga S,et al. Radiation therapy for recurrent esophageal cancer after surgery:clinical results and prognostic factors[J].Jpn J Clin Oncol,2007,37(12):918-923.DOI:10.1093/jjco/hym138.
[8] Nemoto K,Ariga H,Kakuto Y,et al. Radiation therapy for loco-regionally recurrent esophageal cancer after surgery[J].Radiother Oncol,2001,61(2):165-168. DOI:10.1016/S0167-8140(01)00392-9.
[9] Lu JC,Kong C,Tao H.Radiotherapy with or without concurrent chemotherapy for lymph node recurrence after radical surgery of thoracic esophageal squamous cell carcinoma[J].Int J Radiat Oncol Biol Phys, 2010,78(3):710-714.DOI:10.1016/j.ijrobp.2009.08.065.
[10] Jingu K,Nemoto K,Matsushita H,et al. Results of radiation therapy combined with nedaplatin (cis-diammine-glycoplatinum) and 5-Fluorouracil for postoperative locoregional recurrent esophageal cancer[J].BMC Cancer,2006,6:50. DOI:10.1186/1471-2407-6-50.
[11] 章耀鸿,唐喜军,陶瑞康,等.食管癌术后LRR的治疗的疗效分析[J].中华放射肿瘤学杂志,2003,12(2):89-91. DOI:10.3760/j.issn:1004-4221.2003.02.004.
Zhang YH,Tang XJ,Tao RK,et al. Treatment of loco-recurrence after resection of esophageal carcinoma[J].Chin J Radiat Oncol,2003,12(2):89-91.DOI:10.3760/j.issn:1004-4221.2003.02.004.
[12] Kobayashi R,Yamashita H,Okuma K,et al. Salvage radiation therapy and chemoradiation therapy for postoperative locoregional recurrence of esophageal cancer[J].Dis Esophagus,2014,27(1):72-78.DOI:10.1111/dote.12068.
[13] Yamashita H,Nakagawa K,Tago M,et al. Salvage radiotherapy for postoperative loco-regional recurrence of esophageal cancer[J].Dis Esophagus,2005,18(4):215-220. DOI:10.1111/j.1442-2050.2005.00502.x.
[14] Ma DY,Tan BX,Liu M,et al. Concurrent three-dimensional conformal radiotherapy and chemotherapy for postoperative recurrence of mediastinal lymph node metastases in patients with esophageal squamous cell carcinoma:a phase 2 single-institution study[J].Radiat Oncol,2014,9:28.DOI:10.1186/1748-717X-9-28.
[15] Zhu YL,Li Q,Gao JM,et al. A retrospective evaluation of radiotherapy for the treatment of local esophageal squamous cell carcinoma recurrence after initial complete surgical resection[J].J Invest Med,2013,61(1):34-39.DOI:10.2310/JIM.0b013e318276 de92.
[16] 张瑾熔,杨蛟,吕茵,等.91例术后局部复发转移食管癌放疗疗效和预后分析[J].中华放射肿瘤学杂志,2010,19(4):302-305.DOI:10.3760/cma.j.issn.1004-4221.2010.04.007.
Zhang JR,Yang J,Lv Y,et al. Effect of radiotherapy on loco-regional recurrence of esophageal carcinoma after surgery[J].Chin J Radiat Oncol,2010,19(4):302-305. DOI:10.3760/cma.j.issn.1004-4221.2010.04.007.
[17] Bao Y,Liu SL,Zhou QC,et al. Three-dimensional conformal radiotherapy with concurrent chemotherapy for postoperative recurrence of esophageal squamous cell carcinoma:clinical efficacy and failure pattern[J].Radiat Oncol,2013,8:241.DOI:10.1186/1748-717X-8-241.
[18] Wu KL,Chen GY,Xu ZY,et al. Three-dimensional conformal radiation therapy for squamous cell carcinoma of the esophagus:a prospective phase Ⅰ/Ⅱ study[J].Radiother Oncol 2009,93(3):454-457. DOI:10.1016/j.radonc.2009.10.014.
[19] Zhang WW,Zhu YJ,Yang H,et al. Concurrent radiotherapy and weekly chemotherapy of 5-fluorouracil and platinum agents for postoperative locoregional recurrence of oesophageal squamous cell carcinoma[J].Sci Rep,2015,5:8071. DOI:10.1038/srep08071.
[20] Zhang J,Peng F,Li N,et al. Salvage concurrent radio-chemotherapy for post-operative local recurrence of squamous-cell esophageal cancer[J].Radiat Oncol,2012,7:93. DOI:10.1186/1748-717X-7-93.
[21] 张耀文,郑安平,郑志勇,等.468例食管鳞癌术后LRR的三维适形调强放疗疗效及预后分析[J].中华放射医学与防护杂志,2015,35(4):274-279.DOI:10.3760/cma.j.issn.0254-5098.2015.04.009.
Zhang YW,Zheng AP,Zheng ZY,et al. Effect and prognosis of three dimensional conformal intensity modulated radiotherapy on 468 postoperative local recurrent esophageal squamous cell carcinomas[J].Chin J Radiol Med Prot,2015,35(4):274-279.DOI:10.3760/cma.j.issn.0254-5098.2015.04.009.
[22] 王翠微,李呈祥,贺方学.食管癌术后区域淋巴结转移同步加量调强放疗的临床观察[J].中华放射医学与防护杂志,2014,34(9):690-691.DOI:10.3760/cma.j.issn.0254-5098.2014.09.012.
Wang CW,Li CX,He FX.Clinical observation of simultaneous intensity modulated radiotherapy for regional lymph node metastasis after resection of esophageal carcinoma[J].Chin J Radiol Med Protect,2014,34(9):690-691. DOI:10.3760/cma.j.issn.0254-5098.2014.09.012.
[23] Kosuga T,Shiozaki A,Fujiwara H,et al. Treatment outcome and prognosis of patients with lymph node recurrence of thoracic esophageal squamous cell carcinoma after curative resection[J].World J Surg,2011,35(4):798-804.DOI:10.1007/s00268-011-0978-x.
[24] Maruyama K,Motoyama S,Anbai A,et al. Therapeutic strategy for the treatment of postoperative recurrence of esophageal squamous cell carcinoma:clinical efficacy of radiotherapy[J].Dis Esophagus,2011,24(3):166-171. DOI:10.1111/j.1442-2050.2010.01119.x.
[25] Nakamura T,Ota M,Narumiya K,et al. Multimodal treatment for lymph node recurrence of esophageal carcinoma after curative resection[J].Ann Surg Oncol,2008,15(9):2451-2457. DOI:10.1245/s10434-008-0016-x.
[26] Shimada H,Kitabayashi H,Nabeya Y,et al. Treatment response and prognosis of patients after recurrence of esophageal cancer[J].Surgery,2003,133(1):24-31.DOI:10.1067/msy.2003.31.
[27] Jingu K,Matsushita H,Takeda K,et al. Long-term bresults of radiotherapy combined with nedaplatin and 5-fluorouracil for postoperative loco-regional recurrent esophageal cancer:update on a phase Ⅱ study[J].BMC Cancer,2012,12:542.DOI:10.1186/1471-2407-12-542.
[28] 张苏,于长华.食管癌术后纵隔转移灶的放射治疗[J].中华放射肿瘤学杂志,2001,10(1):21-23. DOI:10.3760/j.issn:1004-4221.2001.01.008.
Zhang S,Yu CH.Radiotherapy of mediastinal metastasis after radical operation in esophageal carcinoma[J].Chin J Radiat Oncol,2001,10(1):21-23.DOI:10.3760/j.issn:1004-4221.2001.01.008.
[29] 王玉祥,祝淑钗,李任,等.食管癌术后区域性复发的放疗[J].中华放射肿瘤学杂志,2005,14(2):86-89. DOI:10.3760/j.issn:1004-4221.2005.02.004.
Wang YX,Zhu SC,Li R,et al. Radiotherapy for postoperative regional recurrence in esophageal carcinoma[J].Chin J Radiat Oncol,2005,14(2):86-89. DOI:10.3760/j.issn:1004-4221.2005.02.004.
[30] 朱卫国,韩济华,彭进.食管癌术后局部复发三维适形全程加速超分割放疗的疗效观察[J].中华放射肿瘤学杂志,2007,16(6):480-481.DOI:10.3760/j.issn:1004-4221.2007.06.020.
Zhu WG,Han JH,Peng J.Clinical observation of three dimensional conformal accelerated radiotherapy for postoperative local recurrence of esophageal carcinoma[J].Chin J Radiat Oncol,2007,16(6):480-481. DOI:10.3760/j.issn:1004-4221.2007.06.020.
[31] 苏景伟,祝淑钗,王玉祥,等.145例胸段食管癌术后纵隔淋巴结转移放射治疗的疗效评价[J].中国肿瘤临床,2009,36(11):609-612.DOI:10.3969/j.issn.1000-8179.2009.11.003.
Su JW,Zhu SC,Wang YX,et al. The effect of radiotherapy on 145 cases of mediastinal metastasis from esophageal carcinoma after surgery[J].Chin J Clin Oncol,2009,36(11):609-702.DOI:10.3969/j.issn.1000-8179.2009.11.003.
[32] Miyata H,Yamasaki M,Kurokawa Y,et al. Survival factors in patients with recurrence after curative resection of esophageal squamous cell carcinomas[J].Ann Surg Oncol,2011,18(12):3353-3361.DOI:10.1245/s10434-011-1747-7.
[33] Jingu K,Ariga H,Nemoto K,et al. Long-term results of radiochemotherapy for solitary lymph node metastasis after curative resection of esophageal cancer[J].Int J Radiat Oncol Biol Phys,2012,83(1):172-177.DOI:10.1016/j.ijrobp.2011.06.1978.
[34] Chen XL,Chen TW,Fang ZJ,et al. Patterns of lymph node recurrence after radical surgery impacting on survival of patients with pT1-3N0M0 thoracic esophageal squamous cell carcinoma[J].J Korean Med Sci,2014,29(2):217-223. DOI:10.3346/jkms.2014.29.2.217.
[35] Yano M,Takachi K,Doki Y,et al. Prognosis of patients who develop cervical lymph node recurrence following curative resection for thoracic esophageal cancer[J].Dis Esophagus,2006,19(2):73-77.DOI:10.1111/j.1442-2050.2006.00543.x.