食管癌同步放化疗-课件.ppt

1、食管癌同步放化疗食管癌同步放化疗SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UN

2、IVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY我国食管癌我国食管癌SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG

3、UNIVERSITYlSurgical OncologySurgical OncologylRadiation OncologyRadiation OncologylMedical OncologyMedical OncologylBiological and Target TherapyBiological and Target TherapylThe traditional Chinese medicineThe traditional Chinese medicine治疗手段治疗手段SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN

4、 JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY局部病变局部病变肿瘤治愈肿瘤治愈先先进进的的放放疗疗技技术术新新的的化化疗疗药药物物精精确确放放疗、疗、药药物、物、生生物物靶靶向向治治疗疗肿肿瘤瘤综综合合治治疗疗的的希希望望SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE

5、OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY机制机制SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF X

6、IAN JIAOTONG UNIVERSITY机制机制SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYF Fu u、阿阿霉霉素素二二线线药药物物（9 90 0年年代代以以后）后）泰泰素、素、泰泰索索蒂、蒂、诺诺维维本、本、健健择、择、半半合合成成的的喜喜树树碱碱衍衍生生物、物、新新一一代代铂铂类类生生物物靶靶向向药药物物SECOND AFFILIATED

7、 HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY5Fu抗抗拒拒的的S S期期细细胞胞干干扰扰S S

8、期期调调控控点点实实验验室室证证实，实，放放疗疗期期间间持持续续给给药药可可以以增增敏敏SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL

9、 COLLEGE OF XIAN JIAOTONG UNIVERSITY甲酰四氢叶酸甲酰四氢叶酸顺铂顺铂加强加强5 5FuFu生化调节机制生化调节机制4 4 用药时间用药时间放疗后放疗后5min5min8h8h5 5 用药量用药量200200375mg/m375mg/m2 25 5FuFu特点：特点：SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY新一代

10、新一代 替加氟替加氟 Tegafur Injection 不不需需经经过过肝肝脏脏的的药药物物代代谢谢而而释释放放出出5 5-F Fu u在在血血液、液、淋淋巴巴液、液、腹腹腔腔积积液液以以及及肿肿瘤瘤组组织织中中保保持持高高浓浓度。度。SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYe)希希罗罗达达由由于于最最后后催催化化后后形形成成5 5-F Fu

11、u的的胸胸苷苷磷磷酸酸化化酶酶在在瘤瘤组组织织中中的的浓浓度度为为正正常常组组织织中中的的4 4倍，倍，口口服服后后瘤瘤组组织织中中的的5 5-F Fu u浓浓度度是是静静脉脉给给予予相相同同剂剂量量的的1 12 27 7倍。倍。SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL C

12、OLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY顺铂顺铂 Cisplatin,PDD，DDP 1 铂的金属络合物，作用似烷化剂铂的金属络合物，作用似烷化剂2 主要作用靶点为主要作用靶点为DNA作用于作用于DNA链间及链内交链，形成链间及链内交链，形成DDPDNA复合物复合物干扰干扰DNA复制，或与核蛋白及胞浆蛋白结合。复制，或与核蛋白及胞浆蛋白结合。3 属周期非特异性药属周期非特异性药SECOND AFFILIATED HOSPI

13、TAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY浓度依赖性浓度依赖性时间依赖性时间依赖性顺铂小剂量长期用药顺铂小剂量长期用药抑制肿瘤细胞对放疗所致亚致死性损伤抑制肿瘤细胞对放疗所致亚致死性损伤修复修复抑制抑制和潜在致死性损伤的和潜在致死性损伤的修复修复顺铂顺铂最低临床应用剂量最低临床应用剂量 6mg/m2/dSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE

14、OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY5Fu顺铂顺铂二者对放射增敏有协同作用二者对放射增敏有协同作用增敏效果与给药时间有关增敏效果与给药时间有关顺

15、铂在放疗前顺铂在放疗前16h5Fu持续给药持续给药增敏效果最佳增敏效果最佳SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEG

16、E OF XIAN JIAOTONG UNIVERSITY 泰素、紫素、特素、紫脘素，泰素、紫素、特素、紫脘素，Paclitaxel,Taxol,PTX机制机制SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY机制机制SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERS

17、ITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY健择健择gemcitabine hydrochloride,盐酸盐酸吉西吉西他滨他滨细胞周期特异性抗代谢类药物细胞周期特异性抗代谢类药物 作用于作用于DNADNA合成期（合成期（S S期）的肿瘤细胞期）的肿瘤细胞在一定的条件下，可以阻止在一定的条件下，可以阻止G1G1期向期向S S期的进展期的进展 SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYS

18、ECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AF

19、FILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYlMETHODS.lThis phase III prospective,randomized,and stratified trial was undertaken to evaluate the efficacy of four courses of combined fluorouracil(1000 mg per square meter of body-surface area daily for four days)and cisplatin(75 mg

20、per square meter on the first day)plus 5000 cGy of radiation therapy,as compared with 6400 cGy of radiation therapy alone,in patients with squamous-cell carcinoma or adenocarcinoma of the thoracic esophagus.lRESULTS.lThe median survival was 8.9 months in the radiation-treated patients,as compared wi

21、th 12.5 months in the patients treated with chemotherapy and radiation therapy.In the former group,the survival rates at 12 and 24 months were 33 percent and 10 percent,respectively,whereas they were 50 percent and 38 percent in the patients receiving combined therapy(P less than 0.001).Seven patien

22、ts in the radiotherapy group and 25 in the combined-therapy group were alive at the time of the analysis.验验首首次次证证明明同同步步放放化化疗疗生生存存期期明明显显优优于于单单纯纯放放疗疗这这一一篇篇文文章章被被认认为为是是食食管管癌癌非非手手术术治治疗疗中，中，具具有有里里程程碑碑意意义义的的重重要要论论文。文。本本文文的的发发表表使使得得同同期期放放化化疗疗成成为为食食管管癌癌的的标标准准治治疗疗方方案。案。同同步步放放化化疗疗已已被被美美国国N NC CC CN N推推荐荐治治疗疗不

23、不可可切切除除的的食食管管癌癌患患者。者。SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTO

24、NG UNIVERSITY1级级NCCNSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTON

25、G UNIVERSITY SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVE

26、RSITY合合同同步步化化疗疗(L LC CA AF F+C CT)T)治治疗疗原原发发性性食食管管癌癌的的期期随随机机对对照照研研究究(患患者者1 11 11 1名名)先先予予常常规规放放疗疗D DT T4 41.1.4 4G Gy y/2 23 3f,f,4 4 5 5 W,W,(1.1.8 8G Gy y/次次,1 1次次/天天)缩缩野野行行加加速速超超分分割割,D DT T2 27 7G Gy y/1 18 8次次(1.1.5 5G Gy y/次次,2 2次次/日日)累累积积放放疗疗总总量量6 68 81 14 4 G Gy y/4 41 1f,f,4 44 4d d完完成。成。5 5

27、4 4例例患患者者F FP P方方案案化化疗疗4 4个个周周期期(顺顺铂铂2 25 5m mg g/m m2 2,d d1 1d d3,3,5 5-F FU U6 60 00 0m mg g/m m2 2,d d1 1d d3,3,2 28 8天天为为1 1周周期期)中中位位生生存存期期:3 30.0.8 8月月v vs.s.2 23.3.9 9月月(L LC CA AF F+C CT T v vs.s.L LC CA AF)F)L LC CA AF F+C CT T组组与与L LC CA AF F组组1 1、3 3、5 5 年年生生存存率率分分别别为为6 67 7%、4 44 4%、4 40

28、 0%,7 77 7%、3 39 9%、2 28 8%,(P P=0.0.3 31 10)0)结结论：论：认认为为后后程程加加速速超超分分割割结结合合同同步步化化疗疗有有延延长长生生存存期期的的趋趋势。势。SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XI

29、AN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOT

30、ONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY化化疗疗的的可可行行性性进进行行研研究究6 63 3例例患患者者,其其中中T T1 1a a(粘粘膜膜癌癌)有有2 23 3例例,T

31、T1 1b b(粘粘膜膜下下癌癌)4 40 0例例放放疗疗外外照照射射5 55 56 60 0G Gy y/5 50 06 60 0d,d,同同步步1 13 3周周期期F FP P方方案案化化疗疗,随随后后腔腔内内照照射射1 10 01 12 2G Gy y/2 23 3次。次。5 5年年总总生生存存率率及及无无疾疾病病生生存存率率分分别别为为6 66.6.4 4%和和6 63.3.7 7%;%;T T1 1a a、T T1 1b b 5 5年年无无疾疾病病生生存存率率分分别别为为8 84.4.4 4%、5 50.0.5 5%作作者者认认为为同同步步放放化化疗疗对对I I期期食食管管癌癌的的器

32、器官官保保存存率率为为8 89.9.2 2%,长长期期生生存存率率与与手手术术相相当。当。SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYYamada K,MurakamiM,Okamoto Y,et al.Treatment results of chemoradiotherapy for clinical stage I(T1N0M0)esophag

33、eal carcinoma J.Int J Radiat Oncol Biol Phys,2006,64(4):1106-1111.SECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY第第49届届ASTRO年会报道年会报道(三三)食管癌放疗进展食管癌放疗进展 北京医院放疗科 高鸿 李高峰SECOND AFFILIATED HOSPITAL OF MEDICA

34、L COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITY 2B2B2B级是基于低水平证据，专家组无统一认识，但争议不大级是基于低水平证据，专家组

35、无统一认识，但争议不大 iotherapy,With or Without Surgery,in Treating Patients With Resectable Locally Advanced Cancer of the Esophagus or Gastroesophageal JunctionCondition:EsophagealCancerInterventions:Drug:cisplatin;Drug:filgrastim;Drug:fluorouracil;Drug:paclitaxel;Drug:pegfilgrastim;Procedure:conventionalsu

36、rgery;Procedure:radiationtherapy2Recruiting A Study to Evaluate the Combination of Cetuximab and Chemotherapy as Neoadjuvant Therapy Followed Concomitant Chemoradiotherapy Plus Cetuximab in Locoregional Esophageal CarcinomaCondition:EsophagealCarcinomaIntervention:Drug:cetuximab and chemotherapy(doc

37、etaxel,cisplatin,5-fluorouracil)3Terminated RCT on the Combined Modality Treatment of Squamous Cell Carcinoma of the EsophagusConditions:EsophagealNeoplasms;SquamousCellCancerInterventions:Procedure:transthoracic esophagectomy 2-field extended lymphadenectomy;Drug:neoadjuvant chemotherapy(cisplatin,

38、5-fluorouracil);Radiation:neoadjuvantchemoradiotherapy4Not yet recruiting Chemotherapy Induction and Chemoradiotherapy in Patients With Esophageal CarcinomaCondition:EsophagealCancerInterventions:Drug:5-FU;Drug:Cisplatin;Drug:Taxotere;Biological:Cetuximab;Radiation:Radiation during chemoradio-immuno

39、therapySECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYaxel and Cisplatin With/Without Tarceva in Locally Advanced Esophageal CancerCondition:EsophagealCancerInterventions:Drug:Paclitaxel;Drug:Cisplatin

40、;Drug:Tarceva7Active,not recruiting Neoadjuvant Docetaxel and Cisplatin Plus Chemoradiotherapy Chemoradiotherapy Followed By Surgery in Treating Patients With Locally Advanced,Resectable Esophageal CancerCondition:EsophagealCancerInterventions:Drug:cisplatin;Drug:docetaxel;Procedure:conventionalsurg

41、ery;Procedure:neoadjuvanttherapy;Procedure:radiationtherapy8Active,not recruiting Low-Dose CDGP/5-FU Combined With Radiation for Esophageal CancerConditions:EsophagealCancer;SquamousCellCarcinomaInterventions:Drug:CDGP/5-FU;Radiation:Chemoradiotherapy9Completed CCRT With Twice Weekly Paclitaxel and

42、Cisplatin Followed by Surgery for Locally Advanced Esophageal CancerCondition:EsophagealCancerIntervention:Drug:Paclitaxel,Cisplatin,Surgery,CCRTSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYor Chemor

43、adiotherapy in Esophageal or Gastroesophageal CarcinomaConditions:EsophagealCancer;GastroesophagealCancerInterventions:Drug:5-Fluorouracil;Drug:Oxaliplatin;Radiation:RadiationTherapy11Completed Multi-Center Prospective Randomized Trial Comparing Standard Esophagectomy Against Chemo-Radiotherapy for

44、Treatment of Squamous Esophageal Cancer Early Results From the Chinese University Research Group for Esophageal Cancer(CURE)Condition:EsophagealCancerInterventions:Procedure:Esophagectomy;Procedure:Chemoradiation12Active,not recruiting Radiotherapy,Combination Chemotherapy,and Gefitinib Before and A

45、fter Surgery in Treating Patients With Advanced Esophageal or Gastroesophageal Junction CancerCondition:EsophagealCancerInterventions:Drug:cisplatin;Drug:fluorouracil;Drug:gefitinib;Procedure:adjuvanttherapy;Procedure:conventionalsurgery;Procedure:neoadjuvanttherapy;Procedure:radiationtherapy13Compl

46、eted Combination Chemotherapy Plus Radiation Therapy With or Without Fluorouracil in Treating Patients With Cancer of the Esophagus or StomachConditions:EsophagealCancer;GastricCancerInterventions:Drug:cisplatin;Drug:filgrastim;Drug:fluorouracil;Drug:paclitaxel;Procedure:radiationtherapySECOND AFFIL

47、IATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYSECOND AFFILIATED HOSPITAL OF MEDICAL COLLEGE OF XIAN JIAOTONG UNIVERSITYn Patients With Esophageal Cancer or Rectal CancerConditions:ColorectalCancer;EsophagealCancerInterventions:Procedure:biopsy;Procedure:endoscopicbiopsy;Procedure:gene

48、expressionanalysis;Procedure:laboratorybiomarkeranalysis;Procedure:mutationanalysis;Procedure:polymorphismanalysis15Recruiting Combination Chemotherapy,Surgery,and Radiation Therapy in Treating Patients With Locoregionally Advanced Cancer of the Esophagus,Gastroesophageal Junction,or StomachConditio

49、ns:EsophagealCancer;GastricCancerInterventions:Drug:cisplatin;Drug:epirubicinhydrochloride;Drug:fluorouracil;Drug:oxaliplatin;Procedure:adjuvanttherapy;Procedure:neoadjuvanttherapy;Procedure:radiationtherapy;Procedure:therapeuticconventionalsurgery16Recruiting Advanced Oesophageal Cancer Study to Co

50、mpare Quality of Life and Palliation of Dysphagia.Condition:EsophagusCancerInterventions:Drug:Cisplatin;Radiation:Radiationtherapy;Drug:5-Fluorouacil17Recruiting S-1,Cisplatin,and Radiation Therapy in Treating Patients With Stage IIA,Stage III,or Stage IVA Esophageal Cancer That Can Be Removed by Su