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2 食道癌診療指引 T1b-3,N0-2 T4,N0-2 T1-4,N3 Tany,Nany,M1 106 癌症診療指引370

3 食道癌診療指引共識1-1 ( ) ( : : ) Tis T1a T1b-T3, N0-N2 ( ) ( ) 癌症診療指引371 : 1. Adenocarcinoma; 2. ; 3. <1mm; 4. ; 5.

4 食道癌診療指引共識2-2 ( ) ( : : ) T4, N0-2 T1-4, N3 T any, N any M 癌症診療指引372

5 食道癌診療指引參考文獻 1. NCCN Clinical Practice Guidelines in Oncology: Esophageal and Esophagogastric Junction Cancers Version AJCC Cancer Staging Manual 8th ed p Springer International Publishing, MI:AJCC. 3. Ajani JA, Winter K, Komaki R, et al. Phase II randomized trial of two nonoperative regimens of induction chemotherapy followed by chemoradiation in patients with localized carcinoma of the esophagus: RTOG J Clin Oncol 2008;26: Allum WH, Fogarty PJ, Stenning SP, et al. Long term results of the MRC OEO2 randomized trial of surgery with or without preoperative chemotherapy in resectable esophageal cancer. Proc ASCO GI 2008, abstr 9 5. Bedenne L, Michel P, Bouché O, et al. Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD J Clin Oncol. 2007;25: Bosset JF, Gignoux M, Triboulet JP, et al. Chemoradiotherapy followed by surgery compared with surgery alone in squamous-cell cancer of the esophagus. N Engl J Med 1997;337: Burmeister BH, Smithers BM, Gebski V, et al. Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomised controlled phase III trial.lancet Oncol 2005;6: Cooper JS, Guo MD, Herskovic A, et al. Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Group. JAMA 1999;281: Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Eng J Med 2006;355: Downey RJ, Akhurst T, Ilson D, et al. Whole body 18FDG-PET and the response of esophageal cancer to induction therapy: results of a prospective trial. J Clin Oncol 2003;21: Gaspar LE, Winter K, Kocha WI, et al. A phase I/II study of external beam radiation, brachytherapy, and concurrent chemotherapy for patients with localized carcinoma of the esophagus (Radiation Therapy Oncology Group Study 9207): final report. Cancer 2000;88: 癌症診療指引373

6 癌症診療指引374 Preoperative Chemoradiation Therapy of Esophageal Cancer PREFERRED REGIMENS Paclitaxel + Carboplatin Paclitaxel 50 1 QW 5 1 Carboplatin AUC 2 1 QW 5 Cisplatin + Fluoropyrimidine Cisplatin 75 1 Q4W 2(RT) FU 1000* 1-4 Q4W 2(RT) + 2 Cisplatin Q3W FU Q3W 2

7 mg/m2 癌症診療指引375 Cisplatin 30 1 QW 5 45 Capecitabine 800 PO BID 1-5 QW 5 Oxaliplatin + Fluoropyrimidine Oxaliplatin 85 1 Q2W 3(RT) Leucovorin Q2W 3(RT) FU Q2W 3(RT) FU 800* 1-2 Q2W 3(RT) + 3 Paclitaxel + Carboplatin Oxaliplatin 85 1, 15, 29 For 3 doses 44 Capecitabine 625 PO BID 1-5 QW 5 OTHER REGIMENS Cisplatin + Fluorouracil Cisplatin 100 1, 29 Q35D Fu , Q35D 1

8 + Cisplatin Irinotecan 癌症診療指引376 Irinotecan 65 1, 8, 22, Cisplatin 30 1, 8, 22, 29 1 Paclitaxel + Fluoropyrimidine Paclitaxel 45 1 QW FU 300* 1-5 QW 5 Perioperative Chemotherapy (Include EGJ) PREFERRED REGIMENS ECF modications Epirubicin 50 1 Q3W 6* 9 Cisplatin 60 1 Q3W 6* Capecitabine 625 PO BID 1-21 Q3W 6* *3(pre-op) + 3(post-op)

9 mg/m2 癌症診療指引377 Epirubicin 50 1 Q3W 6* 9 Oxaliplatin Q3W 6* Capecitabine 625 PO BID 1-21 Q3W 6* Oxaliplatin + Fluoropyrimidine *3(pre-op) + 3(post-op) Oxaliplatin 85 1 Q2W 6# 22 Leucovorin Q2W 6# 5-FU Q2W 6# 5-FU 1200* 1-2 Q2W 6# # 3 (pre-op) + 3 (post-op) Oxaliplatin 85 1 Q2W 6# 19 Leucovorin Q2W 6# 5-FU 2600* 1 Q2W 6# # 3 (pre-op) + 3 (post-op) Oxaliplatin Q3W 6# 23 Capecitabine 1000 PO BID 1-14 Q3W 6# # 3 (pre-op) + 3 (post-op)

10 + Fluoropyrimidine Oxaliplatin 癌症診療指引378 Docetaxel 80 1 Q2W 8# 8 Oxaliplatin 85 1 Q2W 8# Leucovorin Q2W 8# 5-FU 2600* 1 Q2W 8# # 4 (pre-op) + 4 (post-op) OTHER REGIMENS Cisplatin + Fluorouracil Cisplatin Q4W 6# 9 5-Fu 800* 1-5 Q4W 6# # 2-3 (pre-op) (post-op)

11 Chemotherapy Preoperative 癌症診療指引379 (Only for adenocarcinoma of the thoracic esophagus or EGJ) Cisplatin + Fluorouracil Cisplatin 80 1 Q3W 2# 10 5-Fu 1000* 1-4 Q3W 2# # 2(pre-op) Definitive Chemoradiation (Non-Surgical) PREFERRED REGIMENS Cisplatin + Fluoropyrimidine Cisplatin 75 1 Q4W 2~4# 11 5-FU 1000* 1-4 Q4W 2~4# # 2 (RT) + 2 Cisplatin 30 1 QW 5 43 Capecitabine 800 PO BID 1-5 QW 5

12 + Fluoropyrimidine Oxaliplatin 癌症診療指引380 Oxaliplatin 85 1 Q2W 6# 5 Leucovorin Q2W 6# 5-FU Q2W 6# 5-FU 800* 1-2 Q2W 6# # 3 (RT) + 3 (post-rt) Oxaliplatin 85 1, 15, 29 For 3 doses 44 Capecitabine 625 PO BID 1-5 QW 5 Paclitaxel + Carboplatin Paclitaxel 50 1 QW 5 1 Carboplatin AUC 2 1 QW 5 OTHER REGIMENS Taxane + Cisplatin Paclitaxel 60 1, 8, 15, Cisplatin

13 mg/m2 癌症診療指引381 Docetaxel 60 1, Cisplatin 80 1, 22 1 Docetaxel 30 1 QW 5 14 Cisplatin 30 1 QW 5 Irinotecan + Cisplatin Irinotecan 65 1, 8, 22, Cisplatin 30 1, 8, 22, 29 1 Paclitaxel + Fluoropyrimidine Paclitaxel QW FU 300* 1-5 QW 5

14 Chemoradiation (Including EGJ) Postoperative 癌症診療指引382 5-FU (bolus) + Leucovorin Lecucovorin Q4W 1st, 3rd, 4th # 15, 46 5-FU Q4W 1st, 3rd, 4th # Lecucovorin , Q5W 2nd (with RT) 5-FU , Q5W 2nd (with RT) 5-FU + Leucovorin modifications 1 cycle before + 2 cycle after chemoradiation # Cycle 1 st (pre-rt), and cycle 3 rd, 4 th (post-rt) Capecitabine 1000 PO BID 1-14 Q4W cycle before + 4 cycle after chemoradiation Leucovorin Q2W FU Q2W FU 1200* 1-2 Q2W # Continuous infusion for 24 hours

15 radiation With 癌症診療指引383 5-FU 200* 1-5 or 1-7 QW 5 with RT 48 Capecitabine 825 PO BID 1-5 or 1-7 QW 5 with RT 49 Postoperative Chemotherapy Oxaliplatin + Capecitabine Oxaliplatin Q3W 16 Capecitabine 1000 PO BID 1-14 Q3W

16 therapy for metastatic or locally advanced cancer Systemic 癌症診療指引384 (where local therapy is not indicated) FIRST-LINE THERAPY Trastuzumab (with chemotherapy) Trastuzumab 8 6 mg/kg 1 Q3W 17 Trastuzumab (with chemotherapy) Trastuzumab 6 4 mg/kg 1 Q2W 17 PREFERRED REGIMENS Fluoropyrimidine + Cisplatin Cisplatin Q4W 18 5-FU 1000* 1-4 Q4W Cisplatin 50 1 Q2W 19, 20 Leucovorin Q2W 5-FU 2000* 1 Q2W

17 mg/m2 癌症診療指引385 Cisplatin 80 1 Q3W 21 Capecitabine 1000 PO BID 1-4 Q3W Fluoropyrimidine + Oxaliplatin Oxaliplatin 85 1 Q2W 22 Leucovorin Q2W 5-FU Q2W 5-FU 1200* 1-2 Q2W Oxaliplatin 85 1 Q2W 19 Leucovorin Q2W 5-FU 2600* 1 Q2W Oxaliplatin Q3W 23 Capecitabine 1000 PO BID 1-14 Q3W

18 REGIMENS OTHER 癌症診療指引386 Paclitaxel + Cisplatin/Carboplatin Paclitaxel Q3W 24 Cisplatin 75 2 Q3W Paclitaxel 90 1 Q2W 25 Cisplatin 50 1 Q2W Paclitaxel Q3W 26 Carboplatin AUC 5 1 Q3W Docetaxel + Cisplatin Docetaxel Q3W 27, 28 Cisplatin Q3W

19 Fluoropyrimidine 癌症診療指引387 Leucovorin Q2W 20 5-FU Q2W 5-FU 1200* 1-2 Q2W 5-FU 800* 1-5 Q4W 19 5-FU 800* 1-5 Q4W 29 Capecitabine 1250 PO BID 1-14 Q3W 30 Taxane Docetaxel Q3W 31, 32 Paclitaxel Q3W 33 Paclitaxel 80 1 QW 34

20 + 5-FU (only for adenocarcinoma) Irinotecan 癌症診療指引388 Irinotecan Q2W 35 Leucovorin Q2W 5-FU Q2W 5-FU 1200* 1-2 Q2W Irinotecan + 5-FU (only for adenocarcinoma) Irinotecan 80 1 QW 6 + 2(off)# 50 Leucovorin QW 6 + 2(off)# 5-FU 2000* 1 QW 6 + 2(off)# ECF #6 weeks treatment, followed by 2 weeks off Epirubicin 50 1 Q3W 39 Cisplatin 60 1 Q3W 5-Fu 200* 1-21 Q3W

21 modifications ECF 癌症診療指引389 Epirubicin 50 1 Q3W 40, 41 Oxaliplatin Q3W 5-Fu 200* 1-21 Q3W Epirubicin 50 1 Q3W 40, 41 Cisplatin 60 1 Q3W Capecitabine 625 PO BID 1-21 Q3W Epirubicin 50 1 Q3W 39 Oxaliplatin Q3W Capecitabine 625 PO BID 1-21 Q3W DCF modifications Docetaxel 40 1 Q2W 36 Leucovorin 40 1 Q2W 5-FU Q2W 5-FU 1000* 1-2 Q2W Cisplatin 40 3 Q2W

22 mg/m2 癌症診療指引390 Docetaxel 50 1 Q2W 37 Oxaliplatin 85 1 Q2W 5-FU 1200* 1-2 Q2W Docetaxel 75 1 Q3W 38 Carboplatin AUC 6 2 Q3W 5-FU 1200* 1-2 Q3W Irinotecan + 5-FU Irinotecan Q2W 6 Leucovorin Q2W 5-FU Q2W 5-FU 1200* 1-2 Q2W Irinotecan 80 1 QW 7 Leucovorin QW 5-FU 2000* 1 QW

23 modifications ECF 癌症診療指引391 Epirubicin 50 1 Q3W 5 Cisplatin 60 1 Q3W Capecitabine 625 PO BID 1-21 Q3W Epirubicin 50 1 Q3W 5 Oxaliplatin Q3W Capecitabine 625 PO BID 1-21 Q3W SECOND-LINE THERAPY PREFERRED REGIMENS Taxane Docetaxel Q3W 21, 22 Paclitaxel Q3W 23 Paclitaxel 80 1, 8, 15, 22 Q4W 24

24 mg/m2 癌症診療指引392 Paclitaxel 80 1, 8, 15 Q4W 25 Irinotecan Irinotecan Q3W 27 Irinotecan Q2W 25, 26 Irinotecan + Fluoropyrimidine (only for adenocarcinoma) Irinotecan Q2W 26 Leucovorin Q2W 5-FU Q2W 5-FU 1200* 1-2 Q2W OTHER REGIMENS Irinotecan + Cisplatin Irinotecan 65 1, 8 Q3W 12, 29 Cisplatin , 8 Q3W

25 (MSI-H/dMMR tumors) Pembrolizumab 癌症診療指引393 Pembrolizumab 200 mg 1 Q3W Van Hagen P, Hulshof MC, van Lanschot, J.J, et al. Preoperative Chemoradiotherapy for Esophageal or Junctional Cancer. N Engl J Med 2012;366: Conroy T, Galais MP, Raoul JL, et al. Definitive chemoradiotherapy with FOLFOX versus fluorouracil and cisplatin in patients with oesophageal cancer (PRODIGE5/ ACCORD17): final results of a randomised, phase 2/3 trial. Lancet Oncol 2014;15: Khushalani NI, Leichman CG, Proulx G, et al. Oxaliplatin in combination with protracted-infusion fluorouracil and radiation: report of a clinical trial for patients with esophageal cancer. J Clin Oncol 2002;20: Tepper J, Krasna MJ, Niedzwiecki D, et al. Phase III trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy,and surgery compared with surgery alone for esophagealcancer: CALGB J Clin Oncol 2008;26: Bedenne L, Michel P, Bouche O, et al. Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD J Clin Oncol 2007; 25: Sharma R, Yang GY, Nava HR, et al. A single institution experience with neoadjuvant chemoradiation (CRT) with irinotecan (I) and cisplatin (C) in locally advanced esophageal carcinoma (LAEC) [abstract]. J Clin Oncol 2009;27 (Suppl 15):Abstract e Ajani JA, Winter K, Okawara GS, et al. Phase II trial of preoperative chemoradiation in patients with localized gastric adenocarcinoma (RTOG 9904): quality of combined modality therapy and pathologic response. J Clin Oncol 2006;24: Al-Batran SE, Hofheinz RD, Pauligk C, et al. Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable

26 or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, gastric 癌症診療指引394 open-label, randomised phase 2/3 trial. Lancet Oncol 2016;17: Ychou M, Boige V, Pignon J-P, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol 2011;29: Alderson D, Langley RE, Nankivell MG, et al. Neoadjuvant chemotherapy for resectable oesophageal and junctional adenocarcinoma: Results from the UK Medical Research Council randomised OEO5 trial (ISRCTN ) [abstract]. J Clin Oncol 2015;33 (15_suppl):Abstract Minsky BD, Pajak TF, Ginsberg RJ, et al. INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: highdose versus standard-dose radiation therapy. J Clin Oncol 2002;20: Urba SG, Orringer MB, Ianettonni M, et al. Concurrent cisplatin, paclitaxel, and radiotherapy as preoperative treatment for patients with locoregional esophagealcarcinoma. Cancer 003;98: Li QQ, Liu MZ, Hu YH, et al. Definitive concomitant chemoradiotherapy with docetaxel and cisplatin in squamous esophageal carcinoma. Dis Esophagus 2010;23: Day FL, Leong T, Ngan S, et al. Phase I trial of docetaxel, cisplatin and concurrent radical radiotherapy in locally advanced oesophageal cancer. Br J Cancer 2011;104: Smalley SR, Benedetti JK, Haller DG, et al. Updated analysis of SWOG-directed intergroup study 0116: a phase III trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection. J Clin Oncol 2012;30: Noh SH, Park SR, Yang HK, et al. Adjuvant capecitabine plus oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): 5-year follow-up of an open-label, randomized phase 3 trial. Lancet Oncol 2014; 15: Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, openlabel, randomised controlled trial. Lancet 2010;376:

27 Lorenzen S, Schuster T, Porschen R, et al. Cetuximab plus cisplatin-5-fluorouracil versus cisplatin-5-fluorouracil alone in 18. 癌症診療指引395 first-line metastatic squamous cell carcinoma of the esophagus: a randomized phase II study of the Arbeitsgemeinschaft Internistische Onkologie. Ann Oncol 2009;20: Al-Batran S-E, Hartmann JT, Probst S, et al. Phase III trial in metastatic gastroesophageal adenocarcinoma with fluorouracil, leucovorin plus either oxaliplatin or cisplatin: a study of the Arbeitsgemeinschaft Internistische Onkologie. J Clin Oncol 2008;26: Bouche O, Raoul JL, Bonnetain F, et al. Randomized multicenter phase II trial of a biweekly regimen of fluorouracil and leucovorin (LV5FU2), LV5FU2 plus cisplatin, or LV5FU2 plus irinotecan in patients with previously untreated metastatic gastric cancer: a Federation Francophone de Cancerologie Digestive Group Study--FFCD J Clin Oncol 2004;22: Kang YK, Kang WK, Shin DB, et al. Capecitabine/cisplatin versus 5-fluorouracil/cisplatin as first-line therapy in patients with advanced gastric cancer: a randomised phase III noninferiority trial. Ann Oncol 2009;20: Enzinger PC, Burtness B, Hollis D, et al. CALGB 80403/ECOG 1206: A randomized phase II study of three standard chemotherapy regimens (ECF, IC, FOLFOX) plus cetuximab in metastatic esophageal and GE junction cancer [abstract]. J Clin Oncol 2010;28 (Suppl 15):Abstract Kim GM, Jeung HC, Rha SY, et al. A randomized phase II trial of S-1-oxaliplatin versus capecitabine-oxaliplatin in advanced gastric cancer. Eur J Cancer 2012;48: Ilson DH, Forastiere A, Arquette M, et al. A phase II trial of paclitaxel and cisplatin in patients with advanced carcinoma of the esophagus. Cancer J 2000;6: Petrasch S, Welt A, Reinacher A, et al. Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer. Br J Cancer 1998;78: Gadgeel SM, Shields AF, Heilbrun LK, et al. Phase II study of paclitaxel and carboplatin in patients with advanced gastric cancer. Am J Clin Oncol 2003;26: Ajani JA, Fodor MB, Tjulandin SA, et al. Phase II multi-institutional randomized trial of docetaxel plus cisplatin with or without fluorouracil in patients with untreated, advanced gastric, or gastroesophageal adenocarcinoma. J Clin Oncol 2005;23:

28 Kim JY, Do YR, Park KU, et al. A multi-center phase II study of docetaxel plus cisplatin as first-line therapy in patients 28. 癌症診療指引396 with metastatic squamous cell esophageal cancer. Cancer Chemother Pharmacol 2010;66: Ohtsu A, Shimada Y, Shirao K, et al. Randomized phase III trial of fluorouracil alone versus fluorouracil plus cisplatin versus uracil and tegafur plus mitomycin in patients with unresectable, advanced gastric cancer: The Japan Clinical Oncology Group Study (JCOG9205). J Clin Oncol 2003;21: Hong YS, Song SY, Lee SI, et al. A phase II trial of capecitabine in previously untreated patients with advanced and/or metastatic gastric cancer. Ann Oncol 2004;15: Albertsson M, Johansson B, Friesland S, et al. Phase II studies on docetaxel alone every third week, or weekly in combination with gemcitabine in patients with primary locally advanced, metastatic, or recurrent esophageal cancer. Med Oncol 2007;24: Ford HE, Marshall A, Bridgewater JA, et al. Docetaxel versus active symptom control for refractory oesophagogastric adenocarcinoma (COUGAR-02): an open-label, phase 3 randomised controlled trial. Lancet Oncol 2014;15: Ajani JA, Ilson DH, Daugherty K, et al. Activity of taxol in patients with squamous cell carcinoma and adenocarcinoma of the esophagus. J Natl Cancer Inst 1994;86: Ilson DH, Wadleigh RG, Leichman LP, Kelsen DP. Paclitaxel given by a weekly 1-h infusion in advanced esophageal cancer. Ann Oncol 2007;18: Guimbaud R, Louvet C, Ries P, et al. Prospective, randomized, multicenter, phase III study of fluorouracil, leucovorin, and irinotecan versus epirubicin, cisplatin, and capecitabine in advanced gastric adenocarcinoma: A French Intergroup (Fédération Francophone de Cancérologie Digestive, Fédération Nationale des Centres de Lutte Contre le Cancer, and Groupe Coopérateur Multidisciplinaire en ncologie) Study. J Clin Oncol 2014;32: Shah MA, Janjigian YY, Stoller R, et al. Randomized multicenter phase II study of modified docetaxel, cisplatin, and fluorouracil (DCF) versus DCF plus growth factor support in patients with metastatic gastric adenocarcinoma: a study of the US Gastric Cancer Consortium. J Clin Oncol 2015;33: Shankaran V, Mulcahy MF, Hochster HS, et al. Docetaxel, oxaliplatin, and 5-fluorouracil for the treatment of metastatic

29 unresectable gastric gastroesophageal junction (GEJ) adenocarcinomas: Preliminary results of a phase II study. or 癌症診療指引397 Gastrointestinal Cancers Symposium 2009:Abstract Elkerm YM, Elsaid A, AL-Batran S, Pauligk C. Final results of a phase II trial of docetaxel-carboplatin-fu in locally advanced gastric carcinoma [abstract]. Presented at the Gastrointestinal Cancers Symposium Abstract Ross P, Nicolson M, Cunningham D, et al. Prospective randomized trial comparing mitomycin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) with epirubicin, cisplatin, and PVI 5-FU in advanced esophagogastric cancer. J Clin Oncol 2002;20: Sumpter K, Harper-Wynne C, Cunningham D, et al. Report of two protocol planned interim analyses in a randomised multicentre phase III study comparing capecitabine with fluorouracil and oxaliplatin with cisplatin in patients with advanced oesophagogastric cancer receiving ECF. Br J Cancer 2005;92: Cunningham D, Starling N, Rao S, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 2008;358: NCCN. [ESOPH-F 7 of 12] esophageal and esophagogastric junction cancers: version 2, Le DT, Durham JN, Smith KN, et al. Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Science2017;357: Javle MM, Yang G, Nwogu CE, et al. Capecitabine, oxaliplatin and radiotherapy: a phase IB neoadjuvant study for esophageal cancer with gene expression analysis. Cancer Invest 2009;27: Lee SS, Kim SB, Park SI, et al. Capecitabine and cisplatin chemotherapy (XP) alone or sequentially combined chemoradiotherapy containing XP regimen in patients with three different settings of stage IV esophageal cancer. Jpn J Clin Oncol 2007;37: Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345: Jansen EP, Boot H, Saunders MP, et al. A phase I-II study of postoperative capecitabine-based chemoradiotherapy in gastric cancer. Int J Radiat Oncol Biol Phys 2007;69: Leong T, Joon DL, Willis D, et al. Adjuvant chemoradiation for gastric cancer using epirubicin, cisplatin, and 5-fluorouracil before and after three-dimensional conformal radiotherapy with concurrent infusional 5-fluorouracil: a

30 49. Lee HS, Choi Y, Hur WJ, et al. Pilot study of postoperative adjuvant chemoradiation for advanced gastric cancer: adjuvant 5-FU/cisplatin and chemoradiation with capecitabine. World J Gastroenterol 2006;12: Wolff K, Wein A, Reulbach U, et al. Weekly high-dose 5-fluorouracil as a 24-h infusion and sodium folinic acid (AIO regimen) plus irinotecan in patients with locally advanced nonresectable and metastatic adenocarcinoma or squamous cell carcinoma of the oesophagus: a phase II trial. Anticancer Drugs 2009;20: study of the trans-tasman radiation oncology group. Int J Radiat Oncol Biol Phys 2011;79: multicenter 癌症診療指引398

31 食道癌放射治療共識 / ( ) 1. (a) / 50Gy(50~50.4Gy) * (b) 48Gy(45~50.4Gy) (c) 27 (25~30 ) ( ) 1. (a) 50Gy(50~50.4Gy) * (b) 48Gy(45~50.4Gy) (c) 27 (25~30 ) * 60~66 Gy 60 Gy ( ) 1. (a) 48Gy(45~50.4Gy) (b) 48Gy(45~50.4Gy) (c) 27 (25~30 ) 癌症診療指引399

32 食道癌放射治療共識 2. (a) 41.4Gy (b) 41.4Gy (c) 23 : 1. International Commission on Radiation Units and Measurements. ICRU Report No 50: Prescribing, Recording and Reporting Photon Beam Therapy. Bethesda, MD: ICRU Publications Cooper JS, GUO MD, Herskovic A, et al. Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial RTOG Radiation Therapy Oncology Group. JAMA 1999;281: International Commission on Radiation Units and Measurements. ICRU Report No 62: Prescribing, Recording and Reporting Photon Beam Therapy. Bethesda, MD: ICRU Publications Shi XH, Yao W, Liu T. Late course accelerated fractionation in radiotherapy of esophageal carcinoma. Raiother Oncol 1999; 51: Minsky BD, Pajak TF, Ginsberg RJ, et al. INT 0123 Radiation Therapy Oncology Group phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol 2002; 20: Willett CG, et al. Principles and Practice of Radiation Oncology. 5th edition: Philadelphia: Lippincott Williams & Wilkins; pp P. van Hagen, M.C.C.M. Hulshof, J.J.B. van Lanschot, et al. Preoperative Chemoradiotherapy for Esophageal or Junctional Cancer. N Engl J Med 2012; 366: NCCN clinical practice guidelines in oncology for esophageal and esophagogastric junction cancers. Version 2, 癌症診療指引400

食道癌診療指引 T1b-3,N0-2 T4,N0-2 T1-4,N3 Tany,Nany,M1 癌症診療指引166

食道癌診療指引 T1b-3,N0-2 T4,N0-2 T1-4,N3 Tany,Nany,M1 癌症診療指引166 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 106 10 25 食道癌診療指引 106 105 106-1.2 T1b-3,N0-2 T4,N0-2 T1-4,N3 Tany,Nany,M1 癌症診療指引166 食道癌診療指引共識1-1 ( ) ( : : ) Tis T1a T1b-T3, N0-N2 ( ) ( ) 癌症診療指引167 : 1.