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Oesophageal cancer: new developments in systemic therapy.
Cancer Treatment Reviews ( IF 11.8 ) Pub Date : 2003-10-31 , DOI: 10.1016/s0305-7372(03)00104-x
David H Ilson 1
Affiliation  

Oesophageal cancer is a rare but highly virulent malignancy in the United States and Western countries, and adenocarcinoma of the oesophagus has had the most rapid rate of increase of any solid tumour malignancy. Systemic metastatic disease is present in 50% of patients at diagnosis, and in the remaining 50% of patients presenting initially with loco-regional disease, systemic metastatic disease will develop in the vast majority of these patients. Combined chemotherapy and radiotherapy is the standard of care in the nonsurgical management of oesophageal cancer. Preoperative chemoradiotherapy followed by surgery continues to be actively studied in the surgical management of locally advanced oesophageal cancer. Pathologic complete responses are seen in 20-40% of patients, with five-year survival achieved in 25-35% of patients. The limited efficacy and substantial toxicity of conventional 5-FU-cisplatin-based chemotherapy combined with radiation, or used to treat advanced disease, has prompted the evaluation of newer agents, including the taxanes and irinotecan. These trials have indicated promising antitumour activity and therapy tolerance in both advanced disease and in combined modality therapy trials, depending on the dose and schedule of therapy administered. The advent of newer, targeted therapies, including agents directed against growth factor receptor pathways, tumour angiogenesis, and tumour invasion and metastasis, is leading to a new generation of clinical trials combining these agents with conventional cytotoxic chemotherapy and radiation.

中文翻译:

食道癌:全身治疗的新进展。

在美国和西方国家,食道癌是一种罕见但剧毒的恶性肿瘤,在所有实体瘤恶性肿瘤中,食道腺癌的增幅最快。在诊断时,有50%的患者存在全身转移性疾病,而在最初出现局部区域性疾病的其余50%的患者中,这些患者中的绝大多数会发展为全身性转移性疾病。食管癌的非手术治疗中,化学疗法和放射疗法相结合是护理的标准。在局部晚期食管癌的外科治疗中,术前放化疗联合手术的积极研究继续得到积极研究。病理完全缓解见于20-40%的患者中,其中25-35%的患者实现了五年生存。传统的基于5-FU-顺铂的化学疗法联合放疗或用于治疗晚期疾病的有限的疗效和明显的毒性,促使人们对包括紫杉烷类药物和伊立替康类在内的新型药物进行评估。这些试验已经表明,在晚期疾病和联合方式治疗试验中,有希望的抗肿瘤活性和治疗耐受性取决于所用治疗的剂量和时间表。新型针对性疗法的出现,包括针对生长因子受体途径,肿瘤血管生成,肿瘤侵袭和转移的药物,正在导致新一代将这些药物与常规细胞毒性化学疗法和放射疗法相结合的临床试验。或用于治疗晚期疾病的药物,已经促使人们评估新的药物,包括紫杉烷类药物和伊立替康。这些试验已经表明,在晚期疾病和联合方式治疗试验中,有希望的抗肿瘤活性和治疗耐受性取决于所用治疗的剂量和时间表。新型针对性疗法的出现,包括针对生长因子受体途径,肿瘤血管生成,肿瘤侵袭和转移的药物,正在导致新一代将这些药物与常规细胞毒性化学疗法和放射疗法相结合的临床试验。或用于治疗晚期疾病的药物,已经促使人们评估新的药物,包括紫杉烷类药物和伊立替康。这些试验已经表明,在晚期疾病和联合方式治疗试验中,有希望的抗肿瘤活性和治疗耐受性取决于所用治疗的剂量和时间表。新型针对性疗法的出现,包括针对生长因子受体途径,肿瘤血管生成,肿瘤侵袭和转移的药物,正在导致新一代将这些药物与常规细胞毒性化学疗法和放射疗法相结合的临床试验。取决于所用的剂量和治疗方案。新型针对性疗法的出现,包括针对生长因子受体途径,肿瘤血管生成,肿瘤侵袭和转移的药物,正在导致新一代将这些药物与常规细胞毒性化学疗法和放射疗法相结合的临床试验。取决于所用的剂量和治疗方案。新型针对性疗法的出现,包括针对生长因子受体途径,肿瘤血管生成,肿瘤侵袭和转移的药物,正在导致新一代将这些药物与常规细胞毒性化学疗法和放射疗法相结合的临床试验。
更新日期:2019-11-01
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