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BJC：食管鳞癌患者的多学科治疗策略研究

2016-11-13 MedSci MedSci原创

食管鳞癌多学科治疗化疗手术
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食管局部晚期鳞状细胞癌(SCC)的标准治疗是顺铂结合5-氟尿嘧啶(CF-RT)的放化疗。这个多中心II期临床试验的对象为最初不能手术切除的局部晚期食管SCC患者，评估多烯紫杉醇+顺铂、5 -氟尿嘧啶(DCF)诱导化疗(ICT)和随后转换手术(CS)的安全性与有效性。 研究纳入临床T4和/或不可切除的锁骨上淋巴结转移患者。开始治疗为三个周期的DCF-ICT，此后如果肿瘤可以切除，则进行CS；如

食管局部晚期鳞状细胞癌(SCC)的标准治疗是顺铂结合5-氟尿嘧啶(CF-RT)的放化疗。这个多中心II期临床试验的对象为最初不能手术切除的局部晚期食管SCC患者，评估多烯紫杉醇+顺铂、5 -氟尿嘧啶(DCF)诱导化疗(ICT)和随后转换手术(CS)的安全性与有效性。

研究纳入临床T4和/或不可切除的锁骨上淋巴结转移患者。开始治疗为三个周期的DCF-ICT，此后如果肿瘤可以切除，则进行CS；如果不能切除，则进行CF-RT，剂量为30–40 Gy，此后再次评估能否切除，如果能，则进行CS，如果不能，则完成60 Gy的CF-RT治疗。主要终点为1年总生存率(OS)。

共有48名患者参加研究，41.7%（n = 20）的患者进行了CS，包括DCF-CS (n=18)、DCF-CF-RT40Gy-CS (n=1)和DCF-CF-RT60Gy-CS (n=1)。19例（39.6%）为R0切除者。术后并发症等级大于或等于3的事件包括喉返神经麻痹、肺部感染、伤口感染、肺瘘、吞咽困难（各一例）；没有发现CS患者出现严重术后并发症。4例(8.3%)患者CF-RT后出现临床完全缓解。估计1年OS为67.9%，80%置信区间的下限为59.7%。接受DCF-CF-RT60Gy治疗的患者中，发生了1例与治疗相关的死亡。

食管局部晚期鳞状细胞癌患者，对于DCF-ICT后CS这种多学科综合治疗策略，有良好的耐受性和疗效。

原始出处：

Tomoya Yokota1, Ken Kato2, Yasuo Hamamoto3, Yasuhiro Tsubosa.Phase II study of chemoselection with docetaxel plus cisplatin and 5-fluorouracil induction chemotherapy and subsequent conversion surgery for locally advanced unresectable oesophageal cancer.British Journal of Cancer advance online publication 3 November 2016

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1822423, encodeId=c72c1822423a9, content=<a href='/topic/show?id=1cdd10294572' target=_blank style='color:#2F92EE;'>#鳞癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102945, encryptionId=1cdd10294572, topicName=鳞癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Wed May 31 16:44:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156890, encodeId=bff11568906a, content=很好，不错，以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sat Nov 19 17:09:44 CST 2016, time=2016-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437161, encodeId=9396143e1611d, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Nov 15 04:44:00 CST 2016, time=2016-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1439820, encodeId=2f09143982047, content=<a href='/topic/show?id=35904318480' target=_blank style='color:#2F92EE;'>#多学科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43184, encryptionId=35904318480, topicName=多学科)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Nov 15 04:44:00 CST 2016, time=2016-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484629, encodeId=0d89148462918, content=<a href='/topic/show?id=3502102944e7' target=_blank style='color:#2F92EE;'>#鳞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102944, encryptionId=3502102944e7, topicName=鳞癌)], attachment=null, authenticateStatus=null, createdAvatar=Bioon/avatar/20171006/a73877485ccdf6add82293e671bebe21.jpg, createdBy=745a7977375, createdName=1696533704_45270456, createdTime=Tue Nov 15 04:44:00 CST 2016, time=2016-11-15, status=1, ipAttribution=)]
    2017-05-31 木头人513

    #鳞癌患者#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1822423, encodeId=c72c1822423a9, content=<a href='/topic/show?id=1cdd10294572' target=_blank style='color:#2F92EE;'>#鳞癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102945, encryptionId=1cdd10294572, topicName=鳞癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Wed May 31 16:44:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156890, encodeId=bff11568906a, content=很好，不错，以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sat Nov 19 17:09:44 CST 2016, time=2016-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437161, encodeId=9396143e1611d, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Nov 15 04:44:00 CST 2016, time=2016-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1439820, encodeId=2f09143982047, content=<a href='/topic/show?id=35904318480' target=_blank style='color:#2F92EE;'>#多学科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43184, encryptionId=35904318480, topicName=多学科)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Nov 15 04:44:00 CST 2016, time=2016-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484629, encodeId=0d89148462918, content=<a href='/topic/show?id=3502102944e7' target=_blank style='color:#2F92EE;'>#鳞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102944, encryptionId=3502102944e7, topicName=鳞癌)], attachment=null, authenticateStatus=null, createdAvatar=Bioon/avatar/20171006/a73877485ccdf6add82293e671bebe21.jpg, createdBy=745a7977375, createdName=1696533704_45270456, createdTime=Tue Nov 15 04:44:00 CST 2016, time=2016-11-15, status=1, ipAttribution=)]
    2016-11-19 李东泽

    很好，不错，以后会多学习

    0

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    2016-11-15 zhouqu_8

    #食管#

    0

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    2016-11-15 zhouqu_8

    #多学科#

    0

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    2016-11-15 1696533704_45270456

    #鳞癌#

    0

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