Treatment of T4 Esophageal Cancer. Definitive Chemo-Radiotherapy vs Chemo-Radiotherapy Followed by Surgery
スポンサーリンク
概要
- 論文の詳細を見る
The outcome of patients with T4 esophageal cancer, defined as a tumor that invades neighboring structures (e.g., aorta, trachea, bronchus, and lung), is extremely poor. Despite recent advances in surgical techniques, these tumors are usually considered inoperable. Two distinct therapeutic options are currently available for T4 esophageal cancers: chemo-radiotherapy followed by surgery (CRT-S), which comprises esophagectomy following down-staging of the tumor by CRT, and definitive chemo-radiotherapy (D-CRT), which is designed to avoid esophagectomy by using maximum doses of irradiation. CRT-S is superior to D-CRT with respect to local control and short-term survival although CRT-S is associated with relatively higher perioperative mortality and morbidity. On the other hand, it is sometimes difficult to achieve local control with D-CRT and the treatment often results in fistula formation, though a complete response to CRT is often associated with better prognosis. Admittedly, the difference in the survival rate between the two modalities is marginal at long-term follow-up due to operative morbidity and inadequate control of distant metastasis in CRT-S. Changes in perioperative management and intensive systemic chemotherapy may enhance the outcome. Randomized controlled trials involving large population samples are needed to define the standard treatment for T4 esophageal cancer.
論文 | ランダム
- F109 ハスモンヨトウの系統間でのBT剤感受性の差(毒理学・殺虫剤作用機構・抵抗性飼育法)
- H201 高知県におけるヒラズハナアザミウマの薬剤感受性(毒物学・殺虫剤作用機構・抵抗性)
- G312 高知県におけるベニフキノメイガの生態と数種BT剤の効果(被害解析 発生予察)
- F325 合成性フェロモンによるハスモンヨトウの防除 : 露地における交信攪乱効果(生理活性物質)
- A403 メロンにおけるタバココナジラミ新系統の要防除密度(発生予察・被害解析)