Table CDR62741 Esophageal Cancer Treatment/食管癌治疗
ID Type Description_en Description_zh
w1 Word Grade 分级
w2 Word Any 任何
w3 Word Tumor Location 肿瘤部位
w4 Word Deaths: 15,210 死亡病例数:15,210例
w5 Word High-grade dysplasia 重度不典型增生
w6 Word Chemoradiation alone 单纯放化疗方案
w7 Word Upper, middle 上段,中段
w8 Word Surgery alone 单纯手术治疗
w9 Word Clinical trials 临床试验
w10 Word Lower, X 较低,X
p1 Phrase Recurrent Esophageal Cancer 复发性食管癌
p2 Phrase New cases: 17,990 新发病例数:17,990例
p3 Phrase Tumor invades adventitia 肿瘤侵及食管纤维膜
p4 Phrase Preoperative Chemotherapy Alone 术前单纯化疗
p5 Phrase Metaplastic columnar epithelium 柱状上皮化生
p6 Phrase recurrent esophageal cancer 复发性食管癌
p7 Phrase Preoperative Chemoradiation Therapy 术前同步放化疗
p8 Phrase Tumor invades submucosa 肿瘤侵及粘膜下层
p9 Phrase Esophageal Cancer Treatment 食管癌的治疗
p10 Phrase stage II esophageal cancer II期食管癌
p11 Phrase stage IV esophageal cancer IV期食管癌
p12 Phrase Tumor invades adjacent structures 肿瘤侵及邻近器官
p13 Phrase stage I esophageal cancer I期食管癌
p14 Phrase Esophageal Cancer (PDQ®): Treatment 食管癌(PDQ®):治疗​
p15 Phrase Nutrition in Cancer Care 癌症治疗中的营养治疗
p16 Phrase Stage III Esophageal Cancer III期食管癌
p17 Phrase Stage II Esophageal Cancer II期食管癌
p18 Phrase Stage I Esophageal Cancer I期食管癌
p19 Phrase Stage IV Esophageal Cancer IV期食管癌
p20 Phrase Tumor invades muscularis propria 肿瘤侵及固有肌层
p21 Phrase Chemoradiation with subsequent surgery 术前放化疗联合手术
p22 Phrase Stage 0 Esophageal Cancer 0期食管癌
p23 Phrase HGD = high-grade dysplasia HGD = 重度不典型增生
p24 Phrase stage III esophageal cancer III期食管癌
p25 Phrase stage 0 esophageal cancer 0期食管癌
p26 Phrase Table 4. Anatomic Stage/Prognostic Groups 表 4. 解剖分期/预后分组
p27 Phrase Table 3. Distant Metastasis (M) 表3. 远处转移(M)
p28 Phrase OS was the primary outcome 试验的主要终点为OS
p29 Phrase Stage Information for Esophageal Cancer 食管癌的分期信息
p30 Phrase Cellular Classification of Esophageal Cancer 食管癌的细胞学分类
p31 Phrase General Information About Esophageal Cancer ​食管癌的基本信息
p32 Phrase Table 1. Primary Tumor (T) 表1. 原发肿瘤(T)
p33 Phrase The optimal surgical procedure is controversial 目前对于优先选用何种手术方式仍有争议
p34 Phrase Table 2. Regional Lymph Nodes (N) 表2. 区域淋巴结(N)
p35 Phrase Nd:YAG endoluminal tumor destruction or electrocoagulation Nd:YAG激光腔内肿瘤毁坏术或电凝术
p36 Phrase Endoscopic-placed stents to provide palliation of dysphagia 内镜下放置支架以缓解吞咽困难
p37 Phrase Clinical trials evaluating single-agent or combination chemotherapy 评估单药化疗或联合化疗的临床试验
p38 Phrase Metaplastic intestinal epithelium with typical goblet cells 有典型杯状细胞的肠上皮化生
p39 Phrase Many agents are active in esophageal cancer 多种药物可有效治疗食管癌
p40 Phrase Resectable tumor invading pleura, pericardium, or diaphragm 可切除肿瘤侵及胸膜、心包或膈肌
p41 Phrase Intraluminal brachytherapy to provide palliation of dysphagia 腔内近距离放射治疗以缓解吞咽困难
p42 Phrase Tumor invades lamina propria or muscularis mucosae 肿瘤侵及固有层或粘膜肌层
s1 Sentence Tumor invades lamina propria, muscularis mucosae, or submucosa 肿瘤只浸润固有层、粘膜肌层或粘膜下层
s2 Sentence The lead reviewers for Esophageal Cancer Treatment are: 食管癌治疗的主要审核人包括:
s3 Sentence Following resection, these patients usually have excellent prognoses 通过切除原发病灶,这些患者通常会有良好预后
s4 Sentence Radiation therapy with or without intraluminal intubation and dilation 放疗伴或不伴腔内置管或扩张术
s5 Sentence Metaplastic parietal cell glandular epithelium within the esophageal wall 食管壁内壁细胞腺上皮化生
s6 Sentence Expert-reviewed information summary about the treatment of esophageal cancer 关于食管癌治疗的专家审核信息总结
s7 Sentence Chemoradiation with subsequent surgery (for patients with stage IVA disease) 术前同步放化疗联合手术(适用于IVA期患者)
s8 Sentence Postoperative complications and in-hospital mortality were equivalent in both groups 而两组的术后并发症及住院死亡率基本相似
s9 Sentence Surgery is the treatment of choice for these small tumors 对于这些小肿瘤,首选治疗是手术
s10 Sentence Barrett esophagus contains glandular epithelium cephalad to the esophagogastric junction Barrett食管含腺上皮,朝胃食管交界处生长
s11 Sentence All recurrent esophageal cancer patients present difficult problems in palliation 所有复发性食管癌患者在姑息治疗中均可能出现多种复杂情况
s12 Sentence The survival rate of patients with esophageal cancer is poor 食管癌患者的生存率较低
s13 Sentence Fewer than 50% of esophageal cancers are squamous cell carcinomas 不到50%的食管癌为鳞状细胞癌
s14 Sentence The cause for the rising incidence and demographic alterations is unknown 引起发病率上升及人口统计学变化的原因尚未可知
s15 Sentence Or mixed histology, including a squamous component or not otherwise specified 或指混合组织病理,包括鳞状细胞成分或未作详细说明
s16 Sentence Dysplasia is particularly likely to develop in the intestinal type mucosa 不典型增生最有可能出现于肠上皮化生粘膜中
s17 Sentence Palliative use of any of the standard therapies, including supportive care 姑息性使用所有标准治疗方案,包括支持治疗
s18 Sentence Esophageal cancer is a treatable disease, but it is rarely curable 食管癌是一种可以治疗但难以治愈的疾病
s19 Sentence Primary treatment modalities include surgery alone or chemotherapy with radiation therapy 主要的治疗方法包括单独手术治疗或同步放化疗
s20 Sentence The most common nonhematologic side effects were anorexia (5%) and fatigue (3%) 而该组中最常见的非血液学副反应为食欲不振(5%)和乏力(3%)
s21 Sentence The addition of chemotherapy did not increase the morbidity associated with surgery 辅助化疗并不增加手术相关死亡率
s22 Sentence Other PDQ summaries containing information related to esophageal cancer include the following: 含食管癌相关信息的其他PDQ总结包括:
s23 Sentence Age alone should not determine therapy for patients with potentially resectable disease 对于可手术切除的患者,不可用单一的年龄因素决定治疗方案
s24 Sentence The majority of the patients enrolled in the study have adenocarcinoma (75%) 大多数入组患者均为食管腺癌(75%)
s25 Sentence Chemotherapy has provided partial responses for patients with metastatic distal esophageal adenocarcinomas 化疗可使转移性远段食管腺癌患者部分缓解
s26 Sentence Gastrointestinal stromal tumors can occur in the esophagus and are usually benign 胃肠道间质瘤可发生于食管,常为良性
s27 Sentence (Refer to the PDQ summary on Gastrointestinal Stromal Tumors Treatment for more information.) (更多信息请参考PDQ总结胃肠道间质瘤的治疗​)
s28 Sentence The occasional patient with very early disease has a better chance of survival 若患者为偶然发现且疾病位于极早期阶段,其治愈的几率则更大
s29 Sentence Unresectable tumor invading other adjacent structures, such as aorta, vertebral body, trachea, etc 不可切除肿瘤侵及其他邻近结构如主动脉、椎体、气管等
s30 Sentence (Refer to the PDQ summary on Nutrition in Cancer Care for more information.) (更多信息请参考PDQ总结癌症治疗中的营养治疗)
s31 Sentence Complete resection of the primary tumor and appropriate lymphadenectomy should be attempted when possible 对于此类患者,原发肿瘤的完全切除联合适当的淋巴结清除术若可能仍应为首选治疗手段
s32 Sentence Estimated new cases and deaths from esophageal cancer in the United States in 2013: 经估计,2013年美国食管癌新发病例和死亡病例数分别为:
s33 Sentence One approach advocates transhiatal esophagectomy with anastomosis of the stomach to the cervical esophagus 现多采用以下两种手术方式:第一种方案采用经食管裂孔食管切除术联合胃代食管、颈部吻合术
s34 Sentence Thoracoscopy and laparoscopy have been used in esophageal cancer staging at some surgical centers 在某些外科中心,胸腔镜和腹腔镜亦被用于食管癌分期
s35 Sentence Special attention to nutritional support is indicated in any patient undergoing treatment of esophageal cancer 对于所有正在进行治疗的食管癌患者,均应特别关注患者的营养支持治疗
s36 Sentence In particular, the classification of involved abdominal lymph nodes as M1 disease has been criticized 特别要注意的是,将腹腔淋巴结受累分入M1的做法存在争议
s37 Sentence The stage determines whether the intent of the therapeutic approach will be curative or palliative 食管癌的分期决定了治疗目标是治愈或缓解症状
s38 Sentence Asymptomatic small tumors confined to the esophageal mucosa or submucosa are detected only by chance 局限于食管粘膜和粘膜下层的无症状性小肿瘤只被偶然发现
s39 Sentence The overall 5-year survival rate in patients amenable to definitive treatment ranges from 5% to 30% 按照标准方案治疗的患者,其总体5年生存率在5%-30%之间
s40 Sentence All patients, whenever possible, should be considered candidates for clinical trials as outlined in treatment overview 所有患者,只要有可能,均应考虑参与本章治疗综述中介绍的临床试验
s41 Sentence A complete pathologic response was achieved in 29% of patients who underwent resection after chemoradiation therapy 在接受同步放化疗的患者中,29%的患者达到病理学完全缓解
s42 Sentence Two randomized trials have shown no significant OS benefit for postoperative radiation therapy over surgery alone 另两项随机临床试验结果显示,术后放疗相比于单纯手术并不能显著提高OS
s43 Sentence Based on these results, preoperative chemotherapy without radiation therapy should still be considered under clinical evaluation 基于上述结果,单纯术前化疗不伴放疗的治疗方案是否有效仍需进一步的临床评估
s44 Sentence Similarly, no differences in long-term quality of life (QOL) using validated QOL instruments have been reported 类似地,亦有研究报道使用QOL认证测定量表进行评估,上述两种不同手术方式的长期生活质量(QOL)并无差异
s45 Sentence The most common hematologic side effects in the chemoradiation group were leukopenia (6%) and neutropenia (2%) 同步放化疗组最常见的血液学副反应为白细胞减少(6%)和中性粒细胞减少(2%)
s46 Sentence In the United States, the median age of patients who present with esophageal cancer is 67 years 在美国,食管癌患者的中位患病年龄为67岁
s47 Sentence Alternative methods of relieving dysphagia have been reported, including laser therapy and electrocoagulation to destroy intraluminal tumor 其他用于缓解吞咽困难症状的治疗手段亦有报道,包括可清除管腔内肿瘤的激光疗法及电凝术
s48 Sentence Updated statistics with estimated new cases and deaths for 2013 (cited American Cancer Society as reference 1) 更新2013年新发病例与死亡病例的统计学​数据(引用美国癌症研究所参考文献1)
s49 Sentence Standard noninvasive staging modalities include computed tomography (CT) of the chest and abdomen and endoscopic ultrasound (EUS) 无创分期方法包括胸腹部的计算机断层扫描(CT)及内镜下超声(EUS)
s50 Sentence The AJCC has designated staging by TNM classification to define cancer of the esophagus and esophagogastric junction AJCC使用TNM分类法对食管癌及胃食管交界处癌进行分期
s51 Sentence The frequency, severity, and duration of reflux symptoms were positively correlated with increased risk of esophageal adenocarcinoma 返流症状的发生频率、严重程度、持续时间均与食管腺癌患病风险呈正相关
s52 Sentence All newly diagnosed patients should be considered candidates for therapies and clinical trials comparing various treatment modalities 所有新诊断的病人,均可接受不同治疗方案,或参与比较不同治疗方案的临床试验
s53 Sentence Other phase III trials have compared preoperative concurrent chemoradiation therapy to surgery alone for patients with esophageal cancer 其他III期临床试验比较了术前同步放化疗方案与单纯手术治疗食管癌患者的疗效
s54 Sentence Strong consideration should be given to resection in patients with high-grade dysplasia in the setting of Barrett metaplasia 对于在Barrett化生粘膜中存在重度不典型增生的患者,强烈建议应予以切除病灶
s55 Sentence The prevalence of Barrett metaplasia in adenocarcinoma of the esophagus suggests that Barrett esophagus is a premalignant condition Barrett化生在食管腺癌中的高发提示Barrett食管是一种癌前病变
s56 Sentence The effects of preoperative chemotherapy are being evaluated in randomized trials, as was done in the NCT00525785 trial 目前多项随机临床试验正在评估术前化疗的疗效,包括NCT00525785试验
s57 Sentence Additionally, there were no significant differences between the two groups with respect to postoperative complications or treatment-related toxicities 此外,两组在术后并发症及治疗相关副作用方面均无显著差异
s58 Sentence Combined modality therapy (i.e., chemotherapy plus surgery, or chemotherapy and radiation therapy plus surgery) is under clinical evaluation 综合治疗(如化疗联合手术、或放化疗联合手术)的效果目前仍处于临床评估阶段
s59 Sentence (1) At least maximal dimension of the tumor must be recorded, and (2) multiple tumors require the T(m) suffix (1) 至少记录肿瘤的最大直径,和 (2)多发肿瘤需标注T(m)下标
s60 Sentence Number must be recorded for total number of regional nodes sampled and total number of reported nodes with metastasis 必须记录所有采样区域淋巴结的总数及转移淋巴结的总数
s61 Sentence An eight-year follow-up of this trial demonstrated an overall survival (OS) rate of 22% for patients receiving chemoradiation therapy 此外,该临床试验的8年随访研究结果显示同步放化疗治疗组患者总生存率为22%
s62 Sentence Endoscopic surveillance of patients with Barrett metaplasia may detect adenocarcinoma at an earlier stage more amenable to curative resection 而对Barrett化生患者采取内镜检测可以发现更早期食管腺癌,并提高治愈性切除的可能性
s63 Sentence Patients with regional and/or celiac axis lymphadenopathy should not necessarily be considered to have unresectable disease caused by metastases 也就是说,无需将存在区域或腹腔干淋巴结肿大的患者看作已有转移且无法切除病灶的病例
s64 Sentence At diagnosis, approximately 50% of patients with esophageal cancer will have metastatic disease and will be candidates for palliative therapy 50%的食管癌患者在诊断时已发生转移且需要接受姑息治疗
s65 Sentence However, there was no significant difference between groups with respect to PFS (5-year PFS, 39% vs 44%; P = .22) 但两组间的PFS无统计学显著差异(5年PFS分别为39%和44%;P=0.22)
s66 Sentence Treatment-related mortality was higher in the surgery group compared with the chemoradiation therapy group (12.8% vs 3.5%, respectively; P < .03) 而在治疗相关死亡率方面,手术组也要高于单纯放化疗治疗组(分别为12.8%与3.5%;P<0.03)
s67 Sentence The presence of positive abdominal lymph nodes does not appear to carry as grave a prognosis as metastases to distant organs 阳性腹腔淋巴结对预后的重要性不如远段脏器转移
s68 Sentence Patients with severe dysplasia in distal esophageal Barrett mucosa often have in situ or even invasive cancer within the dysplastic area 远段食管的Barrett粘膜具有重度不典型增生的患者其不典型增生区域常伴随原位癌甚至浸润癌
s69 Sentence The incidence of esophageal cancer has risen in recent decades, coinciding with a shift in histologic type and primary tumor location 数十年来,食管癌的发病率逐渐上升,同时伴随着组织学类型及原发肿瘤部位的改变
s70 Sentence In an attempt to avoid this perioperative mortality and to relieve dysphagia, definitive radiation therapy in combination with chemotherapy has been studied 为了避免围手术期死亡并同时缓解吞咽困难,一些研究采取了同步放化疗方案
s71 Sentence The results of a population-based, case-controlled study from Sweden strongly suggest that symptomatic gastroesophageal reflux is a risk factor for esophageal adenocarcinoma 瑞典一项基于人群的病例对照研究结果提示症状性胃食管返流症与食管腺癌的发生有很强的相关性
s72 Sentence The current staging system for esophageal cancer is based largely on retrospective data from the Japanese Committee for Registration of Esophageal Carcinoma 现有的食管癌分期系统主要基于日本食管癌登记委员会的回顾性研究数据
s73 Sentence Stage 0 squamous esophageal cancer is rarely seen in the United States, but surgery has been used for this stage of cancer 0期食管鳞状细胞癌在美国极为罕见,但对该期肿瘤手术治疗仍有效
s74 Sentence Location of the primary cancer site is defined by the position of the upper (proximal) edge of the tumor in the esophagus 肿瘤的原发部位指肿瘤的上缘(近段)在食管中的部位
s75 Sentence One of the major difficulties in allocating and comparing treatment modalities for patients with esophageal cancer is the lack of precise preoperative staging 为食管癌病人对比和选择治疗手段时,一个重要难题是缺乏准确的术前分期
s76 Sentence Adenocarcinomas, typically arising in Barrett esophagus, account for at least 50% of malignant lesions, and the incidence of this histology appears to be rising 食管腺癌通常来源于Barrett食管,其在食管恶性病变中的比例超过半数;且其发病率在不断增加
s77 Sentence Effective palliation may be obtained in individual cases with various combinations of surgery, chemotherapy, radiation therapy, stents, photodynamic therapy, and endoscopic therapy with Nd:YAG laser 不同的综合疗法方案对个体病例中有良好的症状缓解作用,这些方案包括联合使用手术、化学疗法、放射治疗、支架治疗、光动力疗法 以及经内镜Nd:YAG激光治疗
s78 Sentence Adenocarcinoma of the esophagus is now more prevalent than squamous cell carcinoma in the United States and western Europe, with most tumors located in the distal esophagus 现在,在美国和西欧,食管腺癌已取代食管鳞癌成为更为常见的组织类型,同时远端食管则成为肿瘤最高发部位
s79 Sentence While risk factors for squamous cell carcinoma of the esophagus have been identified (e.g., tobacco, alcohol, diet), the risk factors associated with esophageal adenocarcinoma are less clear 尽管鳞癌的危险因素已被确认(如烟草、酒精及饮食习惯等),与食管腺癌相关的危险因素却还不清楚
s80 Sentence The presence of Barrett esophagus is associated with an increased risk of developing adenocarcinoma of the esophagus, and chronic reflux is considered the predominant cause of Barrett metaplasia 研究显示Barrett食管与食管腺癌患病风险增加有关,而慢性返流症状被认为是导致Barrett化生的重要原因
s81 Sentence EUS-guided fine-needle aspiration (FNA) for lymph node staging is under prospective evaluation; one retrospective series reported a 93% sensitivity and 100% specificity of regional nodal staging with EUS-FNA EUS引导下细针抽吸穿刺(FNA)用于淋巴结分期仍然处于前瞻性评估阶段;已有一项回顾性系列研究显示,EUS-FNA用于区域淋巴结分期的敏感性和特异性分别为93%和100% 
s82 Sentence Chemoradiation followed by surgery is a standard treatment option for patients with stages IB, II, III, and IVA esophageal cancer, based on the results of several randomized trials 根据一些随机临床试验的结果,术前同步放化疗联合手术治疗是食管癌IB、II、III及IVA期食管癌的标准治疗方案
s83 Sentence Once symptoms are present (e.g., dysphagia, in most cases), esophageal cancers have usually invaded the muscularis propria or beyond and may have metastasized to lymph nodes or other organs 一旦患者出现症状(如多数情况下出现吞咽困难),食管癌通常已经浸润至固有肌层,且可能已出现淋巴结转移或远处转移
s84 Sentence Noninvasive positron emission tomography using the radiolabeled glucose analog 18-F-fluorodeoxy-D-glucose for preoperative staging of esophageal cancer is under clinical evaluation and may be useful in detecting stage IV disease 亦可使用核素标记的葡萄糖类似物18-氟脱氧右旋葡萄糖对食管癌进行术前分期;这一方法可能有助于发现IV期病变,而目前仍在临床评估阶段
s85 Sentence A second approach advocates abdominal mobilization of the stomach and transthoracic excision of the esophagus with anastomosis of the stomach to the upper thoracic esophagus or the cervical esophagus 第二种方案采用经胸食管切除术联合胃代食管、上胸部或颈部吻合术
s86 Sentence One study concluded that transhiatal esophagectomy was associated with lower morbidity than transthoracic esophagectomy with extended en bloc lymphadenectomy; however, median overall disease-free and quality-adjusted survival did not differ significantly 一项研究结果显示,相比于需要进行扩大淋巴结清扫的经胸食管切除术,经食管裂孔食管切除术的死亡率更低;但二者之间,总体中位无病生存期和质量调整生存期并无显著的统计学差异
s87 Sentence Objective response rates of 30% to 60% and median survivals of less than 1 year are commonly reported with platinum-based combination regimens with fluorouracil, taxanes, topoisomerase inhibitors, hydroxyurea, or vinorelbine 含铂类联合方案中常纳入氟尿嘧啶、紫杉烷、拓扑异构酶抑制剂、羟基脲或长春瑞滨,据文献这些联合方案的客观缓解率为30%-60%,中位生存期往往不足1年
s88 Sentence High-grade dysplasia includes all noninvasive neoplastic epithelia that was formerly called carcinoma in situ , a diagnosis that is no longer used for columnar mucosae anywhere in the gastrointestinal tract 重度不典型增生包括所有非浸润性肿瘤性上皮,原称为原位癌,原位癌诊断不再应用于任何胃肠道的柱状粘膜
s89 Sentence Additionally, preoperative chemoradiation improved the rate of R0 resections (R0 is defined as complete resection with no tumor within 1 mm of resection margins, 92% vs 69%, P < .001) 此外,术前同步放化疗方案还可以提高手术R0切除率(R0切除定义为手术切缘1mm以内无肿瘤残留的完全切除术,R0级手术比例分别为92%和69%,P<0.001)
s90 Sentence With a median follow-up of 61 months, the 5-year OS was 55% among patients treated with preoperative chemotherapy compared with 43% among patients treated with postoperative chemotherapy ( P = .04) 中位时间为61个月的随访结果显示,术前化疗组患者的5年OS为55%,而术后化疗组患者的5年OS为43%(P=0.04)
s91 Sentence A Radiation Therapy Oncology Group randomized trial (RTOG-8501) of chemotherapy and radiation therapy versus radiation therapy alone resulted in an improvement in 5-year survival for the combined modality group (27% vs 0%) 肿瘤放射治疗协作组织进行了一项随机临床试验(RTOG-8501),将同步放化疗方案与单纯放疗方案对比,结果显示联合治疗组5年生存率显著提高(分别为27%与0%)
s92 Sentence It is most applicable to patients with squamous cell carcinomas of the upper third and middle third of the esophagus, as opposed to the increasingly common distal esophageal and gastroesophageal junction adenocarcinomas 相比于日趋常见的好发于远段食管和胃食管交界处的食管腺癌,这一分期系统更适用于好发于食管上段与中段三分之一的食管鳞癌
s93 Sentence A subsequent single-institution trial randomly assigned patients (75% with adenocarcinoma) to 5-FU, cisplatin, vinblastine, and radiation therapy (1.5 Gy twice daily to a total of 45 Gy) plus resection versus esophagectomy alone 其后的另一项单中心临床试验将食管癌患者(75%为食管腺癌)随机分为单纯食管切除组和术前放化疗组,后者采用5-FU、顺铂加长春花碱化疗方案联合同步放疗(每次1.5Gy,每天2次,共45Gy)
s94 Sentence Although originally designed to accrue 298 patients, this trial was closed in 1999 after a planned interim analysis showed that it was statistically unlikely that there would be any advantage to using high-dose radiation 虽然该试验最初预计共招募298例受试者,但由于试验中期分析已经提示应用大剂量放疗方案基本无益处,故该试验在1999年已被停止
s95 Sentence The interpretation of the results from both of these trials is challenging because T or N staging was not reported and prerandomization and radiation could be offered at the discretion of the treating oncologist 需要注意的是,出于以下原因上述临床试验的结果解读仍有争议:一方面受试者的肿瘤T或N分期并未在结果中呈现;另一方面,在随机分组前,肿瘤科医师能对患者行放射治疗
s96 Sentence After a median follow-up of 55 months, there were no significant differences between the chemotherapy/surgery and surgery-alone groups in median survival (14.9 months and 16.1 months, respectively) or 2-year survival (35% and 37%, respectively) 经过中位数为55个月的随访期,研究者发现化疗/手术组与单纯手术组在中位生存期(分别为14.9个月和16.1个月)、2年生存率(分别为35%和37%)方面无显著统计学差异
s97 Sentence Surgical treatment of resectable esophageal cancers results in 5-year survival rates of 5% to 30%, with higher survival rates in patients with early-stage cancers. This is associated with a less than 10% operative mortality rate 可切除性食管癌患者经手术治疗后,5年生存率为5%到30%不等,早期患者生存率更高,同时伴随着不到10%的手术死亡率
s98 Sentence An Eastern Cooperative Oncology Group trial (EST-1282) of 135 patients showed that chemotherapy plus radiation provided a better 2-year survival rate than radiation therapy alone, which was similar to that shown in the Intergroup trial 另一项东部肿瘤协作组临床试验(EST-1282)共入组135例患者,结果显示与单纯放射治疗相比,接受同步放化疗患者的2年生存率更高;这一结果亦与上述组间临床试验相似
s99 Sentence In patients with partial esophageal obstruction, dysphagia may, at times, be relieved by placement of an expandable metallic stent or by radiation therapy if the patient has disseminated disease or is not a candidate for surgery 对于存在不完全性食管梗阻的患者,在某些情况下,可以通过放置金属内支架缓解吞咽困难症状;若上述患者肿瘤扩散或不具备手术条件,亦可通过放射性治疗缓解症状
s100 Sentence In the presence of complete esophageal obstruction without clinical evidence of systemic metastasis, surgical excision of the tumor with mobilization of the stomach to replace the esophagus has been the traditional means of relieving the dysphagia 对于已存在完全性食管梗阻,但尚无全身转移证据的患者,解决吞咽困难的传统办法通常是手术切除病灶,并使用胃代食管
s101 Sentence An intergroup trial reported an increase in positive lymph node detection to 56% of 107 evaluable patients using thoracoscopy/laparoscopy, from 41% (using noninvasive staging tests, e.g., CT, magnetic resonance imaging, EUS) with no major complications or deaths 一项组间临床研究结果提示在107例可评估的患者中,若使用无创分期试验如CT、磁共振成像及EUS等,其阳性淋巴结的检出率为41%;若使用有创的胸腔镜/腹腔镜进行分期,该检测率可上升至56%,且无重大并发症或死亡 
s102 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent esophageal cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募复发性食管癌​患者的美国临床研究请参见美国NCI癌症临床研究列表,可根据部位、药物、干预或其他标准进行筛选
s103 Sentence With a median follow-up of 45 months, preoperative chemoradiation was found to improve median OS from 24 months in the surgery-alone group to 49.4 months (hazard ratio [HR], 0.657; 95% confidence interval [CI], 0.495–0.871, P = .003) 经过45个月的中位随访期,研究发现同步放化疗方案组的中位OS为49.4月,而单独手术组的中位OS为24个月(危险比[HR]为0.657;95%置信区间[CI]为0.495-0.871,P=0.003)
s104 Sentence At 2 years' median follow-up, no statistical differences were observed between the high-dose and conventional-dose radiation therapy arms in median survival (13 months vs 18 months), 2-year survival (31% vs 40%), or local/regional failures (56% vs 52%) 在平均2年的随访时间内,大剂量与常规剂量放疗组在中位生存期(分别13月与18月)、2年生存率(分别31%与40%)及局部/区域无效(分别56%与52%)方面均无统计学显著差异
s105 Sentence The overall tumor depth staging accuracy of EUS is 85% to 90%, as compared with 50% to 80% for CT; the accuracy of regional nodal staging is 70% to 80% for EUS and 50% to 70% for CT EUS判断肿瘤浸润深度的总正确率高达85%-90%,CT的正确率为50%-80%;在区域淋巴结转移分期方面,EUS和CT的总正确率分别为70%-80%和50%-70% 
s106 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage IV esophageal cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募IV期食管癌​患者的美国临床研究请参见美国NCI癌症临床研究列表,可根据部位、药物、干预或其他标准进行筛选
s107 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I esophageal cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募I期食管癌​患者的美国临床研究请参见美国NCI癌症临床研究列表,可根据部位、药物、干预或其他标准进行筛选
s108 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III esophageal cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募III期食管癌​患者的美国临床研究请参见美国NCI癌症临床研究列表,可根据部位、药物、干预或其他标准进行筛选
s109 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage 0 esophageal cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募0期食管癌​患者的美国临床研究请参见美国NCI癌症临床研究列表,可根据部位、药物、干预或其他标准进行筛选
s110 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage II esophageal cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募II期食管癌​患者的美国临床研究请参见美国NCI癌症临床研究列表,可根据部位、药物、干预或其他标准进行筛选
s111 Sentence An Intergroup trial (CALGB-9781) planned to randomly assign 475 patients with resectable squamous cell or adenocarcinoma of the thoracic esophagus to treatment with preoperative chemoradiation therapy (5-FU, cisplatin, and 50.4 Gy) followed by esophagectomy and nodal dissection or surgery alone  一项组间临床试验(CALGB-9781)将475例可切除性胸段食管腺癌或鳞癌患者随机为单纯手术组及术前放化疗(5-FU与顺铂,50.4Gy)联合食管切除加淋巴结清扫组
s112 Sentence Local progression-free survival (PFS) was higher in the surgery group (2-year PFS, 64.3%; 95% CI, 52.1%–76.5%) than in the chemoradiation therapy group (2-year PFS, 40.7%; 95% CI, 28.9%–52.5%; HR for arm B vs. arm A, 2.1; 95% CI, 1.3–3.5; P < .003) 关于局部无进展生存率(PFS),手术组(2年PFS为64.3%;95%CI,52.1%-76.5%)则要高于单纯放化疗组(2年PFS为40.7%;95%CI,28.9%-52.5%;B组比A组的HR为2.1;95%CI,1.3-3.5;P<0.003)
s113 Sentence In patients with adenocarcinoma of the esophagus, a single-institution phase III trial demonstrated a modest survival benefit (16 months vs 11 months) for patients treated with induction chemoradiation therapy consisting of 5-FU, cisplatin, and 40 Gy (2.67 Gy fractions) plus surgery over resection alone 另一项单中心的III期临床试验对食管腺癌患者进行了类似对比。该试验采用了术前诱导放化疗方案即5-FU/顺铂方案联合40Gy放疗方案(每次2.67Gy),结果提示与单纯手术组对比,放化疗组患者生存期稍有延长(分别16个月和11个月)
s114 Sentence The analysis of 172 eligible, randomly assigned patients showed that OS at 2 years was not statistically significantly different between the two treatment groups (arm A: 39.9%; 95% CI, 29.4%–50.4%; arm B: 35.4%; 95% CI, 25.2%–45.6%; log-rank test for equivalence with 0.15, P < .007) 通过对随机分组的172例患者随访发现,两治疗组的2年OS不具有统计学差异(A组:39.9%;95%CI,29.4%-50.4%;B组:35.4%;95%CI,25.2%-45.6%;0.15等价性秩和检验,P<0.007)
s115 Sentence In an attempt to improve upon the results of RTOG-8501, Intergroup-0123 (RTOG-9405) randomly assigned 236 patients with localized esophageal tumors to chemoradiation with high-dose radiation therapy (64.8 Gy) and four monthly cycles of fluorouracil (5-FU) and cisplatin versus conventional-dose radiation therapy (50.4 Gy) and the same chemotherapy schedule 在RTOG-8501的基础上,研究者进一步设计了组间试验-0123(RTOG-9405),该试验将236例局限性食管癌患者随机分为两组:试验组采取同步放化疗方案,即大剂量放疗(64.8Gy)联合4个月的氟尿嘧啶(5-FU)+顺铂化疗;对照组为常规剂量放疗(50.4Gy)联合同化疗方案
s116 Sentence At a median follow-up of more than 8 years, there was no significant difference between the surgery alone and combined modality therapy with respect to median survival (17.6 months vs 16.9 months), OS (16% vs 30% at 3 years), or disease-free survival (16% vs 28% at 3 years) 中位随访时间超过8年,结果显示单纯手术治疗组与术前同步放化疗组患者的中位生存期(分别17.6个月和16.9个月)、OS(3年OS分别16%与30%)及无病生存率(3年生存率分别16%和28%)无统计学显著差异
s117 Sentence The results of a retrospective review of 505 consecutive patients who were operated on by a single surgical team over 17 years found no difference in the perioperative mortality, median survival, or palliative benefit of esophagectomy on dysphagia when the group of patients older than 70 years were compared to their younger peers 一项回顾性研究共纳入由同一手术团队在17年间连续手术的505例食管癌患者,结果显示年龄大于70岁的患者与小于70岁的患者相比,围手术期死亡率、中位生存期及食管切除术对于吞咽困难的缓解作用均无统计学显著差异 
s118 Sentence A multicenter prospective randomized trial in which preoperative combined chemotherapy (i.e., cisplatin) and radiation therapy (37 Gy in 3.7 Gy fractions) followed by surgery was compared to surgery alone in patients with squamous cell carcinoma showed no improvement in OS and a significantly higher postoperative mortality (12% vs 4%) in the combined modality arm 一项多中心前瞻性随机临床试验在食管鳞状细胞癌患者中进行了上述对比,该研究采用了术前化疗(如顺铂)联合同步放疗(37Gy,每次3.7Gy)方案。与单纯手术组对比,术前同步放化疗组患者的OS无显著差异,且术后死亡率显著增加(分别12%与4%)
s119 Sentence The ongoing CROSS (NCT01498289) study randomly assigned 366 patients with resectable esophageal or junctional cancers to receive either surgery alone or weekly administration of carboplatin (dose titrated to achieve an AUC [area under the curve] of 2 mg/mL/minute) and paclitaxel (50 mg/m2 of BSA [body surface area]) and concurrent radiation therapy (41.4 Gy in 23 fractions) administered over 5 weeks 正在进行的CROSS(NCT01498289)研究有366例可切除性食管或胃食管交界处肿瘤患者随机分为两组,一组仅接受手术治疗;另一组则在术前每周给予卡铂(剂量滴定至AUC[曲线下面积]为2mg/mL/min)加紫杉醇(根据BSA[体表面积]计算,50mg/m2)联合同步放疗(41.4Gy,分23次),共5周
s120 Sentence A phase III German trial also compared induction chemotherapy (three courses of bolus 5-FU, leucovorin, etoposide, and cisplatin) followed by chemoradiation therapy (cisplatin, etoposide, and 40 Gy) followed by surgery (arm A), or the same induction chemotherapy followed by chemoradiation therapy (at least 65 Gy) without surgery (arm B) for patients with T3 or T4 squamous cell carcinoma of the esophagus 德国一项III期临床试验在T3或T4期食管鳞状细胞癌患者中对以下两种治疗方案进行比较:第一种治疗方案为诱导化疗(推注注射5-FU、亚叶酸、依托泊苷及顺铂,共3程)加后续同步放化疗(顺铂、依托泊苷,40Gy)联合手术(A组);第二种治疗方案为上述同方案诱导化疗,并同步放化疗(至少65Gy),不联合手术(B组)
s121 Sentence The trial was closed as a result of poor patient accrual; however, the results of the 56 enrolled patients, with a median follow-up of 6 years, were reported. The median survival was 4.48 years (95% CI, 2.4 years to not estimable) for trimodality therapy versus 1.79 years (95% CI, 1.41–2.59 years) for surgery alone ( P = .002), with 5-year OS of 39% (95% CI, 21%–57%) versus 16% (95% CI, 5%–33%) for trimodality therapy versus surgery alone 该项临床试验由于患者入组困难而被迫停止;但已入组的56例患者及中位数为6年的随访结果显示,三方案联合组的中位生存期为4.48年(95%CI,2.4年-不可估计),单纯手术组为1.79年(95%CI,1.41-2.59年);联合治疗组的5年生存率为39%(95%CI,21%-57%),单纯手术组为16%(95%CI,5%-33%)