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2025, 05, v.44 591-597
食管鳞状细胞癌术后中西医治疗及不良预后因素研究进展
基金项目(Foundation): 首都卫生发展科研专项重点攻关项目(批文号:首发2022-1-4151); 北京市科技计划课题——AI+健康协同创新培育项目(编号:Z221100003522021); 中央高水平中医医院临床科研业务费项目(编号:HLCMHPP2023001,HLCMHPP2023097)
邮箱(Email): qfm2020jieli@yeah.net;
DOI: 10.16295/j.cnki.0257-358x.2025.05.020
发布时间: 2025-05-05
出版时间: 2025-05-05
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摘要:

食管鳞状细胞癌是我国食管癌的主要病理类型,其复发转移是影响术后患者远期生存的重要因素,也是影响疗效提升的关键因素。文章综述了食管鳞状细胞癌术后西医辅助治疗进展和包含中医加载治疗、巩固治疗的中西医结合治疗模式,提出筛选并量化不良预后因素是降低复发转移率的有效手段。发挥术后综合治疗模式的优势,遵循精准治疗理念,寻找不良预后因素,构建临床预测模型,聚焦凸显优势人群特性的有效方案,对中西医结合防治食管鳞状细胞癌术后复发转移具有重要意义。参考文献66篇。

Abstract:

Esophageal squamous cell carcinoma(ESCC) is the main pathological type of esophageal carcinoma in China,and its recurrence and metastasis are important factors affecting the long-term survival of postoperative patients,as well as key factors affecting the improvement of efficacy. This article reviews the progress of adjuvant therapy for ESCC after surgery and the treatment mode of integrated traditional Chinese and Western medicine,including loading therapy and consolidation therapy with traditional Chinese medicine,and proposes that screening and quantify-ing adverse prognostic factors is an effective means to reduce recurrence and metastasis rates. It is of great significance to fully utilize the advantages of the postoperative comprehensive treatment mode,follow the concept of precise treatment,identify adverse prognostic factors,construct clinical prediction models,and focus on highlighting effective programs with dominant population characteristics for the prevention and treatment of postoperative recurrence and metastasis of esophageal squamous cell carcinoma using integrated traditional Chinese and Western medicine. There are 66 references.

参考文献

[1] BRAY F,LAVERSANNE M,SUNG H,et al. Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin,2024,74(3):229-263.

[2] HAN B F,ZHENG R S,ZENG H M,et al. Cancer incidence and mortality in China,2022[J]. J Natl Cancer Cent,2024,4(1):47-53.

[3] CHEN R,ZHENG R S,ZHANG S W,et al. Patterns and trends in esophageal cancer incidence and mortality in China:an analysis based on cancer registry data[J]. J Natl Cancer Cent,2023,3(1):21-27.

[4] LI P,JING J,LIU W J,et al. Spatiotemporal patterns of esophageal cancer burden attributable to behavioral,metabolic,and dietary risk factors from 1990 to 2019:longitudinal observational study[J]. JMIR Public Health Surveill,2023,9:e46051.

[5] CAI Y Q,LIN J X,WEI W B,et al. Burden of esophageal cancer and its attributable risk factors in 204countries and territories from 1990 to 2019[J]. Front Public Health,2022,10:952087.

[6]宋颂,雷林,刘涵,等.中国人群食管癌疾病负担:多数据源证据汇总及分析[J].中华肿瘤防治杂志,2023,30(15):887-896.

[7] SUNG H,FERLAY J,SIEGEL R L,et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin,2021,71(3):209-249.

[8] CHEN S M,CAO Z,PRETTNER K,et al. Estimates and projections of the global economic cost of 29 cancers in 204 countries and territories from 2020 to 2050[J]. JAMA Oncol,2023,9(4):465-472.

[9] UHLENHOPP D J,THEN E O,SUNKARA T,et al. Epidemiology of esophageal cancer:update in global trends,etiology and risk factors[J]. Clin J Gastroenterol,2020,13(6):1010-1021.

[10] SANTUCCI C,MIGNOZZI S,MALVEZZI M,et al.Global trends in esophageal cancer mortality with predictions to 2025,and in incidence by histotype[J].Cancer Epidemiol,2023,87:102486.

[11]中华人民共和国国家卫生健康委员会医政医管局.食管癌诊疗指南(2022年版)[J].中华消化外科杂志,2022,21(10):1247-1268.

[12]郭康,马洁,朱建飞,等.颈段和胸上段食管鳞状细胞癌术后辅助化疗的预后意义[J].中国胸心血管外科临床杂志,2022,29(12):1580-1586.

[13] ANDO N,IIZUKA T,IDE H,et al. Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus:a Japan clinical oncology group study:JCOG9204[J]. J Clin Oncol,2003,21(24):4592-4596.

[14] ZHANG L Z,LI W W,LYU X,et al. Adjuvant chemotherapy with paclitaxel and cisplatin in lymph nodepositive thoracic esophageal squamous cell carcinoma[J]. Chung Kuo Yen Cheng Yen Chiu,2017,29(2):149-155.

[15] BAIU I,BACKHUS L. Esophageal cancer surgery[J].JAMA,2020,324(15):1580.

[16]黄伟钊,傅剑华,胡祎,等.食管癌术后辅助化疗价值的Meta分析[J].癌症,2006,25(10):1303-1306.

[17] ZHAO P L,YAN W P,FU H,et al. Efficacy of postoperative adjuvant chemotherapy for esophageal squamous cell carcinoma:a meta-analysis[J]. Thorac Cancer,2018,9(8):1048-1055.

[18] XIAO Z F,YANG Z Y,LIANG J,et al. Value of radiotherapy after radical surgery for esophageal carcinoma:a report of 495 patients[J]. Ann Thorac Surg,2003,75(2):331-336.

[19] SCHREIBER D,RINEER J,VONGTAMA D,et al. Impact of postoperative radiation after esophagectomy for esophageal cancer[J]. J Thorac Oncol,2010,5(2):244-250.

[20] CHEN J Q,ZHU J,PAN J J,et al. Postoperative radiotherapy improved survival of poor prognostic squamous cell carcinoma esophagus[J]. Ann Thorac Surg,2010,90(2):435-442.

[21] SONG S,CHIE E K,KIM H J,et al. Role of postoperative radiotherapy for microscopic margin involvement in the squamous cell carcinoma of esophagus[J]. Cancer Res Treat,2013,45(3):202-209.

[22] LI Y,LIU H S,SUN C,et al. Comparison of clinical efficacy of neoadjuvant chemoradiation therapy between lower and higher radiation doses for carcinoma of the esophagus and gastroesophageal junction:a systematic review[J]. Int J Radiat Oncol Biol Phys,2021,111(2):405-416.

[23] YU S F,ZHANG W C,NI W J,et al. A propensityscore matching analysis comparing long-term survival of surgery alone and postoperative treatment for patients in node positive or stage III esophageal squamous cell carcinoma after R0 esophagectomy[J]. Radiother Oncol,2019,140:159-166.

[24] YANG J S,ZHANG W C,XIAO Z F,et al. The impact of postoperative conformal radiotherapy after radical surgery on survival and recurrence in pathologic T3N0M0 esophageal carcinoma:a propensity scorematched analysis[J]. J Thorac Oncol,2017,12(7):1143-1151.

[25] KANG J J,CHANG J Y,SUN X,et al. Role of postoperative concurrent chemoradiotherapy for esophageal carcinoma:a meta-analysis of 2165 patients[J]. J Cancer,2018,9(3):584-593.

[26]曹秀峰,吕进,朱斌,等.局部晚期食管鳞状细胞癌术后放疗和化疗的前瞻性研究[J].中华肿瘤杂志,2010,32(6):452-455.

[27]邓霞,张萍,谢聪颖.术后放疗与术后同步放化疗治疗食管癌临床研究[J].实用肿瘤杂志,2013,28(3):294-298.

[28]罗志强,黄燕,康恭礼,等. 60例Ⅲ期食管癌三维适形放疗同步化疗与单纯放疗的疗效比较[J].中国现代医生,2014,52(31):154-156,160.

[29] KELLY R J,AJANI J A,KUZDZAL J,et al. Adjuvant nivolumab in resected esophageal or gastroesophageal junction cancer[J]. N Engl J Med,2021,384(13):1191-1203.

[30] SCHNEIDER B J,CHANG A C. ASO perspectives:adjuvant nivolumab in resected esophageal or gastroesophageal junction cancer:never stop questioning[J].Ann Surg Oncol,2022,29(5):2735-2738.

[31] VISBAL A L,ALLEN M S,MILLER D L,et al. Ivor Lewis esophagogastrectomy for esophageal cancer[J].Ann Thorac Surg,2001,71(6):1803-1808.

[32]邱祥南,朱锡旭.食管癌根治术后区域复发的治疗进展[J].癌症进展,2019,17(19):2233-2236,2287.

[33] SU X D,ZHANG D K,ZHANG X,et al. Prognostic factors in patients with recurrence after complete resection of esophageal squamous cell carcinoma[J]. J Thorac Dis,2014,6(7):949-957.

[34] GUO X F,MAO T,GU Z T,et al. Clinical study on postoperative recurrence in patients with pN0 esophageal squamous cell carcinoma[J]. J Cardiothorac Surg,2014,9:150.

[35] MARIETTE C,PIESSEN G,BRIEZ N,et al. The number of metastatic lymph nodes and the ratio between metastatic and examined lymph nodes are independent prognostic factors in esophageal cancer regardless of neoadjuvant chemoradiation or lymphadenectomy extent[J]. Ann Surg,2008,247(2):365-371.

[36]沈文斌,高红梅,祝淑钗,等.Ⅱ和Ⅲ期胸段食管鳞癌术后不同辅助治疗方式治疗后的失败模式分析[J].肿瘤防治研究,2017,44(5):340-346.

[37]彭孟凡,田硕,李晨辉,等.食管癌发病机制及中医药临床干预研究进展[J].中国实验方剂学杂志,2022,28(12):267-274.

[38]周慧灵,郑佳彬,马雪娇,等.林洪生固本清源理论指导下的恶性肿瘤“五治”治疗经验[J].中华中医药杂志,2020,35(1):195-198.

[39]金长娟,李蕾,崔清,等.食管癌术后中西医综合治疗临床观察[J].肿瘤,2003,23(5):429-431.

[40]崔清,郭毅峻,张铭,等.食道通结方联合化疗治疗中晚期食管癌术后患者临床疗效观察[J].上海中医药大学学报,2015,29(6):29-32.

[41]陈亚楠,孙旭,蒋立峰,等.中医药防治食管鳞癌术后复发转移的临床观察:一项单臂前瞻性研究[J].现代肿瘤医学,2021,29(11):1949-1952.

[42]陈继欣,陈淑琪,吴万垠.中药干预食管癌术后辅助化疗的疗效及相关指标变化的Meta分析[C]//广东中医药研究促进会,广州中医药大学,广州中医药大学附属医院.首届广东中医科学大会暨中美肿瘤学高峰论坛论文集.广州:广东中医药研究促进会,广州中医药大学,广州中医药大学附属医院. 2018:287-300.

[43]张玉双.启膈方对Ⅰ-Ⅲ期食管癌根治术后患者生存质量及无病生存时间的影响[D].石家庄:河北医科大学,2017.

[44]王雯倩.中医辨证论治干预食管癌术后复发转移的回顾性研究[D].南京:南京中医药大学,2015.

[45]吴成亚.食管癌术后相关症状的临床特征分析及辨证中药干预的疗效观察[D].北京:中国中医科学院,2018.

[46]李释心.芪术郁灵汤对食管癌术后放化疗后患者的干预及预后生存关系的研究[D].北京:北京中医药大学,2022.

[47] MARCUS P M,FREEDMAN A N,KHOURY M J. Targeted cancer screening in average-risk individuals[J].Am J Prev Med,2015,49(5):765-771.

[48] ZHANG Y W,GAO J H,ZHENG A P,et al. Definition and risk factors of early recurrence based on affecting prognosis of esophageal squamous cell carcinoma patients after radical resection[J]. Transl Oncol,2021,14(6):101066.

[49]张玉双,贾蕾,史会娟,等.食管癌术后复发转移影响因素分析[J].中华中医药学刊,2020,38(9):60-63.

[50] PENNATHUR A,GIBSON M,JOBE B,et al. Oesophageal carcinoma[J]. Lancet,2013,381(9864):400-412.

[51] MARIETTE C,DAHAN L,MORNEX F,et al. Surgery alone versus chemoradiotherapy followed by surgery for stage I and II esophageal cancer:final analysis of randomized controlled phase III trial FFCD 9901[J].J Clin Oncol,2014,32(23):2416-2422.

[52] VAN HAGEN P,HULSHOF MCCM,VAN LANSCHOT JJB,et al. Preoperative chemoradiotherapy for esophageal or junctional cancer[J]. N Engl J Med,2012,366(22):2074-2084.

[53] RONG L L,WANG B Z,GUO L,et al. HER2 expression and relevant clinicopathological features in esophageal squamous cell carcinoma in a Chinese population[J].Diagn Pathol,2020,15(1):27.

[54]缪艳,殷鸿,李姗姗,等.食管鳞癌患者预后营养指数与炎症反应标志物相关性分析[J].肿瘤代谢与营养电子杂志,2021,8(3):274-278.

[55]李晓明,向宗骏,万志渝,等.外周血炎性指标比值对中晚期食管鳞癌术后复发的预测价值[J].中国胸心血管外科临床杂志,2019,26(9):865-869.

[56]莫航沣,陈亚萍,韩慧,等.临床预测模型研究方法与步骤[J].中国循证医学杂志,2024,24(2):228-236.

[57]常笑.食管癌根治术后病理分期、复发风险预测以及分层放射治疗的系列研究[D].北京:北京协和医学院,2022.

[58]胡世宇. pT1-3N0M0食管鳞癌术后复发的高危因素及预测模型[D].青岛:青岛大学,2024.

[59]黄玲玲,余鎏,赵泉,等.基于增强CT影像组学模型预测食管癌患者放化疗完全缓解后肿瘤复发的价值[J].中国临床医学影像杂志,2023,34(2):91-96.

[60]穆艾太尔·麦提努日,马乐,叶建蔚,等.结合炎症指标的临床评分模型对食管癌患者术后生存情况的预测价值[J].消化肿瘤杂志(电子版),2023,15(1):34-38.

[61]田菲,庞得全,韩朵,等. pT2N0M0期胸段食管鳞癌术后局部复发预测模型的建立和分析[J].肿瘤预防与治疗,2021,34(3):214-220.

[62]蔡盼盼.真实世界晚期食管癌中医优势人群特征分析[D].北京:北京中医药大学,2019.

[63]陈佳阳,李淏,张育荣,等.中医治疗晚期食道癌优势人群特征分析[J].北京中医药,2021,40(8):880-882.

[64]陈佳阳,刘婷婷,周睿,等.中药治疗72例晚期食管癌预后因素分析[J].北京中医药大学学报,2022,45(5):446-451.

[65]陈佳阳,杨宇飞,易丹辉,等.中医治疗晚期食道癌分析及预后判别[J].基础医学与临床,2020,40(2):182-186.

[66]许博文,张潇潇,李杰,等.基于优势人群的肿瘤中医药防治疗效提升策略[J].中医杂志,2022,63(4):318-322.

基本信息:

DOI:10.16295/j.cnki.0257-358x.2025.05.020

中图分类号:R735.1

引用信息:

[1]许博文,朱广辉,李杰,等.食管鳞状细胞癌术后中西医治疗及不良预后因素研究进展[J].山东中医杂志,2025,44(05):591-597.DOI:10.16295/j.cnki.0257-358x.2025.05.020.

基金信息:

首都卫生发展科研专项重点攻关项目(批文号:首发2022-1-4151); 北京市科技计划课题——AI+健康协同创新培育项目(编号:Z221100003522021); 中央高水平中医医院临床科研业务费项目(编号:HLCMHPP2023001,HLCMHPP2023097)

发布时间:

2025-05-05

出版时间:

2025-05-05

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