食管癌术后辅助治疗现况

摘要

食管癌是高度恶性的消化道肿瘤,目前手术切除虽是治疗食管癌的最好方法,但手术治疗有一定的局限性,如容易复发和转移.因此,食管癌患者根治性切除术后是否需要放疗、化疗等辅助治疗,特别是在我国,由于缺乏循证医学的证据,尚存许多争论.目前认为,对于淋巴结转移阳性患者,术后辅助放疗有一定的意义,其中淋巴结转移阳性枚数是重要指标.而对于年轻、残端阳性、局部淋巴结转移患者,术后辅以放疗联合化疗是必须的治疗手段.而对于食管癌的分子靶向治疗,目前尚处于萌芽阶段,也是食管癌治疗研究的重点,并具有广阔的前景.食管痛的生物学特性与地域有一定的关系,因此,如何进行食管癌术后辅助治疗,根据术后病理学类型、淋巴结转移及手术切除情况等来选择放、化疗至关重要.本文就食管癌术后辅助放、化疗等现状以及术后辅助治疗的推荐流程作一论述.%Esophageal cancer arc highly malignant alimentary tract tumors.For the treatment of esophageal cancer, surgical excision is currently considered as the best choice.However, surgery has some limitations, such as local relapse and metastasism, therefote, it remains controversial whether patients with radical resection need radiotherapy,chemotherapy and other adjuvant therapy.This is especially important in China due to the lack of evidence based medicine.Regarding to the current view, it has some significance that patients with positive lymph node metastases should received postoperative radiotherapy.As the matter of fact, the number of lymph node metastasis is also an important indicator for these patients As for the young patients with stump-positive and lymph node metastasis.postoperative radiotherapy combined with chemotheapy is necessary.Thc molecular targeted therapy for esophagcal cancer, still in its infancy, is also an important area of the study in future esophageal cancer treatment.In fact, the biological characteristics of esophageal cancer have a certain relationship with epidemiology.So, it is important for patients to choose radiotherapy or chemotherapy according to postoperative pathological type, lymph node status,and surgical removal fields.In this text, we reviewed the current adjuvant therapy status of esophageal cancer and recommend the adjuvant therapy pathway.