Buscar en
Cirugía Española
Toda la web
Inicio Cirugía Española Tratamiento adyuvante y neoadyuvante del cáncer de esófago. Evolución y estad...
Información de la revista
Vol. 71. Núm. 5.
Páginas 247-256 (Mayo 2002)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 71. Núm. 5.
Páginas 247-256 (Mayo 2002)
Acceso a texto completo
Tratamiento adyuvante y neoadyuvante del cáncer de esófago. Evolución y estado actual
Adjuvant and neoadjuvant therapy of esophageal cancer. Development and current situation
Visitas
8403
José Roiga,1
Autor para correspondencia
roigmerino@racclub.net

Correspondencia: Dr. J. Roig García. Santander, 5 A, 2.º 1.ª. 17005 Girona. España.
, Jordi Gironèsb, Antoni Codina-Barrerab, José I. Rodríguezb, Antoni Codina-Cazadorc
a Jefe de Sección de la Unidad de Cirugía Gastroesofágica
b Médico Adjunto
c Jefe del Servicio de Cirugía General y Digestiva. Servicio de Cirugía General y Aparato Digestivo. Hospital Universitario de Girona Dr. Josep Trueta. Girona. España
Este artículo ha recibido
Información del artículo
Resumen

El tratamiento adyuvante y neoadyuvante del cáncer de esófago es un tema que sigue siendo controvertido. Los ensayos realizados en las últimas 2 décadas han permitido aclarar algunos conceptos y marcar las futuras líneas de trabajo e investigación. Mientras el tratamiento adyuvante va perdiendo fuerza, el neoadyuvante demuestra ser prometedor. A falta de los resultados de los ensayos en curso, se ha demostrado efectivo en el control local de la enfermedad, en la disminución de las recidivas y, en algún caso, en la supervivencia postoperatoria.

Se efectúa una revisión de los principales trabajos hasta la actualidad y se marcan las líneas de trabajo en un futuro inmediato.

Palabras clave:
Cáncer de esófago
Tratamiento adyuvante
neoadyuvante

Adjuvant and neoadjuvant therapy of esophageal cancer remains controversial. The trials performed in the last decade have elucidated certain concepts and defined future areas of research. While adjuvant therapy is falling out of favor, neoadjuvant therapy is promising. Although the results of current trials are lacking, this therapy has been shown to be effective in local control of the disease, reduction of recurrence and, in certain cases, in postoperative survival.

We review the main studies published to date and end by outlining research areas in the immediate future.

Key words:
Esoghageal cancer
Adjuvant
neoadjuvant therapy
El Texto completo está disponible en PDF
Bibliografía
[1.]
A. Forastiere, S. Urba.
Combined modality therapy for cancer of esophagus.
Princ Pract Oncol Updates, 10 (1996), pp. 1-15
[2.]
W. Mei, G. Xiang-Zhi, Y. Weibo.
Randomized clinical trial on the combination of the preoperative irradiation and surgery in the treatment of esophageal carcinoma: report of 206 patients.
Int J Radiat Oncol Biol Phys, 16 (1989), pp. 325-327
[3.]
M. Gignoux, A. Russel, B. Paillot, M. Gillet, P. Schlag, J.P. Favre, et al.
The value of preoperative radiotherapy in esophageal cancer.
Results of a study of the EORTC.World J Surg, 11 (1987), pp. 426-432
[4.]
B. Launois, D. Delarue, J.P. Campion, M. Kerbaol.
Preoperative radiotherapy for carcinoma of the esophagus.
Surg Gynecol Obstet, 153 (1981), pp. 690-692
[5.]
K. Nygaard, S. Hagen, H.S. Hansen, R. Hatlevoll, R. Hultborn, A. Jakobsen, et al.
Preoperative radiotherapy prolongs survival in operable esophageal carcinoma: a randomized multicenter study of preoperative radiotherapy and chemoterapy.
The secons Scandinavian trial in esophageal cancer.World J Surg, 16 (1992), pp. 1104-1110
[6.]
S.J. Arnott, W. Duncan, G.R. Kerr, P.R. Walbaum, E. Cameron, W.J. Jack, et al.
Low dose preoperative radiotherapy for carcinoma of the esophagus: results of a randomized clinical trial.
Radiother Oncol, 24 (1992), pp. 108-113
[7.]
P.M. Schlag.
Randomized trial of preoperative chemotherapy for squamous cell cancer of the esophagus. The Cirurgische Arbeitgemeinschaft Fuer Onkologie der Deutschen Gesellschaft Fuer Chirurgie Studie Group.
Arch Surg, 127 (1992), pp. 1446-1450
[8.]
J.A. Roth, H.I. Pass, N.M. Flanagan, G.M. Graeber, J.C. Rosenberg, S. Steinberg.
Randomized clinical trial of preoperative and postoperative adjuvant chemotherapy with cisplatin, vindesine, and bleomicycin for carcinoma of the esophagus.
J Thorac Cardiovasc Surg, 96 (1988), pp. 242-248
[9.]
D.P. Kelsen, R. Ginsberg, T.F. Pajak, D.G. Sheahan, L. Gunderson, J. Mortimer, et al.
Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer.
N Engl J Med, 339 (1998), pp. 1979-1984
[10.]
D.P. Kelsen.
Neoadjuvant therapy of esophageal cancer.
Cancer J Sci Am, 3 (1997), pp. 137-139
[11.]
J.S. Cooper, M.D. Guo, A. Herskovic, J.S. McDonald, J.A. Martenson, M. Al-Sarraf, et al.
Chemoradiotherapy of localli advanced esophageal cancer: long-term follow-up of a prospectiv randomized trial (ROTG 85-01.
Radiation Therapy Oncology Group. JAMA, 281 (1995), pp. 1623-1627
[12.]
A. Herskovic, L. Leichman, P. Lattin, I. Han, K. Ahmad, G. Leichman, et al.
Chemoradiation with and without surgery in the thoracic esophagus: the Wayne State experience.
Int J Radiat Oncol Biol Phys, 15 (1988), pp. 655-662
[13.]
L.R. Coia, P.F. Engstrom, A.R. Paul, P.M. Stafford, G.E. Hanks.
Long term results of infusional 5-FU, mitomicin-C and radiation as primary manegemet of esophageal carcinoma.
Int J Radiat Oncol Biol Phys, 20 (1991), pp. 29-36
[14.]
Prise E.A. Le, B.C. Meunier, P.L. Etienne, V.C. Julienne, D.M. Gedouin, J.L. Raoul, et al.
Sequential chemotheray and radiotherapy for patients with squamous cell carcinoma of the esophagus.
Cancer, 75 (1995), pp. 430-434
[15.]
D.H. Ilson, A. Forastiere, M. Arquette, F. Costa, R. Heelan, Y. Huang, et al.
A phase II trial of paclitaxel and cisplatin in patients with advanced carcinoma of the esophagus.
Cancer J, 6 (2000), pp. 316-323
[16.]
L.R. Coia, B.D. Minsky, B.A. Berkey, M.J. John, D. Haller, J. Landry, et al.
Outcome of patientes receiving radiation for cancer of the esophagus: results of the 1992-1994 Patterns of Care Study.
J Clin Oncol, 18 (2000), pp. 455-463
[17.]
B.H. Burmeister, G. Dickie, B.M. Smithers, R. Hodge, K. Morton.
Thirtyfour patients with carcinoma of the cervical esophagus treated with chemoradiation therapy.
Arch Otolaryngol Head Neck Surg, 126 (2000), pp. 205-208
[18.]
C.M. Araujo, L. Souhami, R. Gil, R. Carvalho, J.A. García, M.J. Froimtchuk, et al.
A randomized trial comparing radiation therapy versus concomitant radiation therapy and chemotherapy in carcinoma of the thoracic esophagus.
Cancer, 67 (1991), pp. 2258-2261
[19.]
T.J. Smith, L.M. Ryan, HO Jr Douglass, D.G. Haller, Y. Dayal, J. Kirkwood, et al.
Combined chemoradiotherapy vs. radiotherapy alone for early stage squamous cell carcinoma of the esophagus: a study of the Eastern Cooperative Oncology Group.
Int J Radiat Oncol, 42 (1998), pp. 269-276
[20.]
A. Herskovic, K. Martz, M. al-Sarraf, L. Leichman, J. Brindle, V. Vaitkeviciu, et al.
Combined chemotheraphy and radiotherapy compared with radiotherapy alone in patients with cancer of the esophagus.
N Engl J Med, 326 (1992), pp. l593-1598
[21.]
M. aI-Sarraf, K. Martz, A. Herskovic, L. Leichman, J.S. Brindle, V.K. Vaitkevicius, et al.
Progress report of combined chemoradiotherapy versus radiotherapy alone in patients with esophageal cancer: an intergroup study.
J Clin Oncol, 15 (1997), pp. 277-284
[22.]
B.D. Minsky, D. Neuberg, D.P. Kelsen, T.M. Pisansky, R. Ginsberg, A. Benson.
Neoadjuvanl chemotherapy plus concurrent chemotherapy and high-dose radiation for squamous cell carcinoma of the esophagus: a preliminary analysis of the phase II intergroup trial 0122.
J Clin Oncol, 14 (1996), pp. 49-155
[23.]
R. Franklin, Z. Steiger, G. Vaishampayan, I. Asfaw, Rosenberg, J. Loh, et al.
Combined modality therapy for esophageal squamous cell carcinoma.
Cancer, 51 (1983), pp. 1062-1071
[24.]
K.S. Naunheim, P. Petruska, T.S. Roy, C.H. Andrus, F.E. Johnson, J.M. Schlueter, et al.
Preoperative chemotherapy and radiotherapy for esophageal carcinoma.
J Thorac Cardiovasc Surg, 103 (1992), pp. 887-895
[25.]
H.G. Seydel, L. Leichman, R. Byhardt, J. Cooper, A. Herskovic, J. Libnock, et al.
Preoperative radiation and chemotherapy for localized squamous cell carcinoma of the esophagus: a RTOG sludy.
Int J Radiat Oncol Biol Phys, 14 (1988), pp. 33-35
[26.]
S.G. Urba, M.B. Orringer, C. Pérez-Tamayo, J. Bromberg, A. Forastiere.
Concurrent preoperative chemotherapy and radiation therapy in localized esophageal adenocarcinoma.
Cancer, 69 (1992), pp. 285-291
[27.]
S.M. Keller, L.R. Coia, L. Ryan, P. Dang, D.J. Vaught, C. Diggs, et al.
Chemoradiation followed by esophagectomy for adenocarcinoma of the esophagus and gastro-esophageal junction: results of a phase II study of the Eastern Cooperative Oncology Group.
Proc Annu Meet Am Soc Clin Oncol, 14 (1995), pp. 463
[28.]
A.A. Forastiere, M.B. Orringer, C. Pérez-Tamayo, S.G. Urba, M. Zahurak.
Preoperative chemoradiation followed by transhiatal esophagectomy for carcinoma of the esophagus: final report.
J Clin Oncol, 11 (1993), pp. 1118-1123
[29.]
E. Poplin, T. Fleming, L. Leichman, H.G. Seydel, Z. Steiger, S. Taylor, et al.
Combined therapies for squamous cell carcinoma of the esophagus. A Southwest Oncology Group Study (SWOG-81137.
J Clin Oncol, 5 (1987), pp. 622-628
[30.]
L. Leichman, Z. Steiger, H.G. Seydel.
Preoperative chemotherapy and radiation therapy for patients with cancer of the esophagus: a potentially curative approach.
J Clin Oncol, 2 (1984), pp. 75-79
[31.]
G. Ganem, B. Dubray, Y. Raoul, P. Colin, E. Bardet, J.Y. Douillard, et al.
Concomitant chemoradiotherapy folloved, where feasible, by surgery for cancer of the esophagus.
J Clin Oncol, 15 (1997), pp. 701-711
[32.]
M.C. Posner, W.E. Gooding, R.J. Landreneau, M.M. Rosenstein, M.R. Clarke, M.S. Peterson, et al.
Preoperative chemoradiotherapy for carcinoma of the esophagus and gastroesophageal junction.
Cancer J Sci Am, 4 (1998), pp. 237-246
[33.]
A.A. Forastiere, R.F. Heitmiller, D.J. Lee, M. Zahurak, R. Abrams, L. Kleinberg, et al.
Intensive chemoradiation followed by esophagectomy, by squamous cell and adenocarcinoma of the esophagus.
Cancer J Sci Am, 3 (1997), pp. 144-152
[34.]
E. Heath, B. Burtness, R.F. Heitmiller, R. Salem, L. Kleinberg, J.P. Kniseley, et al.
Phase II evaluation of preoperative chemoradiation and postoperative adjuvant chemotherapy for squamous cell and adenocarcinoma of the esophagus.
J Clin Oncol, 18 (2000), pp. 868-877
[35.]
E. Prise Le, P.L. Etienne, B. Meunier, G. Maddern, Hassel M. Ben, D. Gedouin, et al.
A randomized study of chemotherapy. Radiation therapy and surgery versus surgery for localized squamous cell carcinoma of the esophagus.
Cancer, 73 (1994), pp. 1779-1784
[36.]
J.F. Bosset, M. Gignoux, J.P. Triboulet, E. Tiret, G. Mantion, D. Elias, et al.
Chemoradiotherapy followed by surgery compared with surgery alone in squamous cell cancer of the esophagus.
N Engl J Surg, 337 (1997), pp. 161-167
[37.]
S. Urba, M. Orringer, A. Turrusi, M. Iannettoni, A. Forastiere, M. Strawderman.
A randomized trial comparing surgery (S) to preoperalive concomitant chemoradiation plus surgery in patients (pts) with resectable esophageal cancer (CA): updated analysis.
Proc Annu Meet Am Soc Clin Oncol, 16 (1997), pp. 983
[38.]
T.N. Walsh, N. Noonan, D. Hollywood, A. Kelly, N. Keeling, T.P. Henessy.
A comparation of multimodal therapy and surgery for esophageal adenocarcinoma.
N Engl J Med, 335 (1996), pp. 462-467
[39.]
R.F. Heitmiller, A.A. Forastiere, L. Kleinberg, M. Zahurak.
Neoadjuvant chemoradiation followed by surgery for resectable esophageal cancer.
Recent Results Cancer Res, 155 (2000), pp. 95-104
[40.]
M.A. Chidel, T.W. Rice, D.J. Adelstein, P.A. Kupelian, J.H. Suh, M. Becker.
Resectable esophageal carcinoma: local control with neoadju-vant chemotherapy and radiation therapy.
[41.]
N. Ando, S. Ozawa, Y. Kitagawa, Y. Shinozawa, M. Kitajima.
Improvement in the Results of Surgical Treatment of Advanced Squamous Esophageal Carcinoma during 15 consecutive years.
Ann Surg, 232 (2000), pp. 235-242
[42.]
A. Chan, A. Wong.
Is combined chemotherapy and radiation therapy equally effective as a surgical resection in localized esophageal carcinoma?.
Int J Radiat Oncol Biol Phys, 45 (1999), pp. 265-270
[43.]
K.S. Wilson, J.T. Lim.
Primary chemo-radiotherapy and selective oesophagectomy for oesophageal cancer: goal of cure with organ preservation.
Radiother Oncol, 54 (2000), pp. 129-134
[44.]
R.M. Goldberg.
Gastroesophageal cancers: forward motion?.
Am Soc Clin Oncol, 1092-911 (2000), pp. 504-510
[45.]
H.J. Stei, A. Sendler, U. Fink, J.R. Siewert.
Multidisciplinary approach to eophageal and gástric cancer.
Surg Clin North Am, 80 (2000), pp. 659-682
[46.]
J. McDonald, S. Smalley, J. Benedetti, S.A. Hundahl, N.C. Estes, G.N. Stemmermann, et al.
Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction.
N Engl J Med, 345 (2001), pp. 725-730
[47.]
R.J. Ginsberg.
Options in adenocarcinoma of the esophagus: Which quarterback? The palliative and potentially curative benefits that result from surgery.
Am Soc Clin Oncol, 1092-9118/00 (2000), pp. 511-515
Copyright © 2002. Asociación Española de Cirujanos
Opciones de artículo
Herramientas
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos