Lokal İleri Evre Özefagus Kanserinde Kemoradyoterapi Deneyimimiz

Abstract

Amaç: Bu çalışmada lokal ileri evre özefagus kanseri tanısıyla neoadjuvan/ definitif kemoradyoterapi (KRT) uygulanan hastaların sonuçlarının bildirilmesi amaçlanmıştır. Hastalar ve Yöntem: Histolojik tanısı skuamöz hücreli 10, adenokarsinom 4, adenoskuamöz karsinom 1 olan, T3N0M0 5 veya T3N1M0/T4N0M0 10, toplam 15 hasta geriye dönük olarak incelendi. Ortanca radyoterapi dozu 50 Gy (1,8-2 Gy/gün, 5 fraksiyon/hafta) olup eş zamanlı kemoterapi radyoterapinin ilk ve son hafta sisplatin ve 5-florourasil olarak uygulandı. Bulgular: Eş zamanlı kemoterapinin kesintisiz uygulanabilirlik oranı %80 idi. Medyan takip 15 ay (aralık, 3-70 ay) idi. Neoadjuvan olarak tedavi edilen beş hastadan birinde lokal progresyon, üçünde uzak metastaz izlendi. Baştan definitif KRT planlanan hastalardan üçüne (%30) evrede küçülme izlenerek cerrahi önerildi. İki yıllık lokal kontrol (LK) %22, uzak metastazsız sağkalım (UMSK) %45 ve genel sağkalım (GSK) %31 olarak saptandı. Derece III disfaji oranı %6 idi. Sonuç: Lokal ileri evre özefagus kanserinde tedavi tartışmalıdır. Cerrahi şansını elde eden hastalarda daha uzun sağkalım ve lokal kontrol bildirilirken üçlü modalite tedavilerin yapılabilirliği merkezin deneyimi ile sınırlıdır. Bu nedenle tüm hastalar bireysel olarak ve multidisipliner yaklaşım ile değerlendirilmelidir. (Marmara Üniversitesi Tıp Fakültesi Dergisi 2012;25:74-7)

Anahtar Kelimeler: Cerrahi, Lokal ileri evre, Kemoradyoterapi, Özefagus kanseri

Keywords

• Cerrahi, Lokal ileri evre, Kemoradyoterapi, Özefaguskanseri

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