1例中晚期食管癌新辅助放化疗联合微创手术治疗探讨  

Neoadjuvant chemoradiotherapy combined with mini-invasive esophagectomy in advanced esophageal cancer: A case report

作　　者：唐鹏[1] 段晓峰[1] 姜宏景[1] 于振涛[1] 肖建宇[2] 战忠利[3] 庞青松[4] 李鸿立[5] 

机构地区：[1]天津医科大学肿瘤医院食管肿瘤科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津市300060 [2]天津医科大学肿瘤医院放射科,天津市300060 [3]天津医科大学肿瘤医院病理科,天津市300060 [4]天津医科大学肿瘤医院放疗科,天津市300060 [5]天津医科大学肿瘤医院消化肿瘤内科,天津市300060

出　　处：《中国肿瘤临床》2014年第6期399-403,共5页Chinese Journal of Clinical Oncology

摘　　要：局部晚期食管癌不可切除率及根治术后复发率较高。新辅助放化疗联合手术切除是最常见的食管癌多学科综合治疗方法之一,具有以下优点:减少肿瘤负荷,降低肿瘤分期,提高R0切除率;控制微转移,提高肿瘤局部控制率,改善预后。传统开胸手术通常伴随较高的并发症发生率和死亡率,影响术后生活质量;而胸腔镜辅助微创手术可有效减少手术创伤,加快术后恢复,且具有与开胸手术相似的远期疗效。现介绍1例经天津医科大学肿瘤医院食管肿瘤科治疗的进展期食管癌新辅助放化疗结合胸腔镜微创手术治疗的病例,该患者经多学科协作诊疗后效果较好。通过报道该病例诊治以促进食管癌新辅助治疗及微创外科经验交流,推动多学科间的合作。Advanced esophageal cancer without distant metastasis remains a potentially curable disease, but the prognosis is poorer in this condition than in the early stage because of a high unresectability rate at presentation and a much higher recurrence rate after radical surgery. The administration of neoadjuvant chemoradiotherapy has several potential benefits for advanced esophageal can- cer. This treatment can reduce tumor volume, decrease tumor stage, and improve R0 resection rate; can act on micrometastases, im-prove local control rate, and improve prognosis; and can evaluate tumor sensitivity to cytotoxic medications. Compared with the in- creased morbidity and mortality by traditional open procedure, mini-invasive esophagectomy has been associated with less blood loss, reduced postoperative pain, decreased time in the intensive care unit, and shortened length of hospital stay, but with similar long-term prognosis. The current study presents an advanced esophageal cancer patient who underwent neoadjuvant chemoradiotherapy combined with mini-invasive esophagectomy in our hospital. The multimodal treatment achieved a favorable curative effect for the patient. The re- port aims to promote comprehensive integration of esophageal cancer neoadjuvant therapy and mini-invasive procedure. This study can also enhance interdisciplinary communication and cooperation among medical colleagues in the same fields.

关 键 词：食管癌 新辅助放化疗 胸腔镜食管癌切除术 多学科协作 

分 类 号：R735.1[医药卫生—肿瘤]