Treatment options for esophageal cancer

Treatment options for esophageal cancer include:

(I) Treatment of esophageal cancer that can be removed endoscopically and surgically

For patients with stage 0 esophageal cancer and some stage 1 esophageal cancers, endoscopic resection can be performed with regular follow-up if the lesions are shallow, small and localized. If the lesions are extensive, originate from multiple points or are incompletely resected under endoscopy, surgical treatment should be performed. Most stage 1, stage II and stage III esophageal cancers can be treated with comprehensive treatment with surgery as the main treatment. Patients with stage IIb or above can choose concurrent preoperative chemoradiotherapy. The recommended preoperative radiotherapy dose is 40 to 50 Gy within 4 to 5 weeks, and surgery should be performed 4 to 6 weeks after the end of irradiation. The recommended chemotherapy regimen is the FP (fluorouracil, cisplatin) regimen.

2. Treatment of unresectable esophageal cancer

For patients in stage IV who cannot undergo surgery or are unwilling to undergo surgery, comprehensive treatment with radiotherapy as the main treatment can be adopted. If chemotherapy can be tolerated, concurrent radiotherapy and chemotherapy are recommended. The chemotherapy regimen is mainly fluorouracil plus cisplatin. When surgery is not possible and chemotherapy cannot be tolerated, the best supportive treatment is recommended.

The best supportive treatment includes: ① stent implantation for obstruction; ② nutritional therapy; ② analgesic therapy; ④ arm dilation therapy.

3. Treatment of recurrent and distant metastatic esophageal cancer

For patients with local recurrence, those who have undergone surgery but not chemoradiotherapy are recommended to receive chemoradiotherapy and endoscopic treatment. Surgery is also an option. For those who have undergone chemoradiotherapy but not surgery, surgery should be performed if the tumor can be surgically removed. For those who cannot undergo surgery, palliative radiotherapy, chemotherapy or supportive treatment is given. Supportive treatment is generally given to those with distant metastasis.