关键词: 食管胃结合部腺癌, 化疗, 放疗, 围手术期, 综合治疗

Abstract:

Rational use and appraisal of perioperative chemotherapy and radiotherapy for adenocarcinoma of the esophagogastric junction        HU Jian-kun, CHEN Xin-zu. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
Corresponding author: HU Jian-kun, E-mail: hujkwch@126.com
Abstract    The primary treatment of adenocarcinoma of the  esophagogastric junction (AEG) is surgery, but more than 50% of curatively resected patients undergo recurrence or cancer-related death during postoperative 5 years. It implies multidisciplinary treatment of radio- and chemotherapy is still necessary. Recently, neoadjuvant therapy has been paid more attention to, and neoadjuvant radiotherapy is currently considered able to improve 5-year overall survival. Moreover, European Organization for Research and Treatment of Cancer has made a consensus guideline of neoadjuvant radiotherapy for AEG, which is useful in clinical practice. Neoadjuvant chemotherapy is meaningful to increase R0 resection rate, but should combine adjuvant chemotherapy to improve overall survival. Concept on adjuvant chemotherapy is according to gastric cancer, and NCCN guideline recommends classic ECF or modified ECF regimens. Results of monotherapy S1 trial also showed improved overall survival. The evidence of intra- or postoperative radiotherapy is poor and can not improve long term survival. Therefore, preoperative concurrent  chemoradiotherapy plus postoperative chemotherapy is currently preferable multidisciplinary treatment model.

Key words: adenocarcinoma of esophagogastric junction, chemotherapy, radiotherapy, perioperative peroid, multidisciplinary therapy