@article{oai:shiga-med.repo.nii.ac.jp:00003784,
 author = {KODAMA, Hirokazu and TAKEBAYASHI, Katsushi and KAIDA, Sachiko and ISHIKAWA, Ken and YAMAGUCHI, Tsuyoshi and MIYAKE, Toru and IIDA, Hiroya and TOKUDA, Aya and MAEKAWA, Takeru and MURAMOTO, Keiji and MAEHIRA, Hiromitsu and KOJIMA, Masatsugu and UEKI, Tomoyuki and TANI, Masaji and 児玉, 泰一 and 竹林, 克士 and 貝田, 佐知子 and 石川, 健 and 山口, 剛 and 三宅, 亨 and 飯田, 洋也 and 徳田, 彩 and 前川, 毅 and 村本, 圭史 and 前平, 博充 and 小島, 正継 and 植木, 智之 and 谷, 眞至},
 issue = {1},
 journal = {滋賀医科大学雑誌},
 month = {Jan},
 note = {【背景】遠隔転移のない切除不能局所進行食道癌に対する標準治療は根治的化学放射線療法(CRT)だが，近年Docetaxel/5-FU/ Cisplatin 療法をはじめとした導入化学療法（ICT）からの外科的切除の有用性が報告されている．今回，当院での切除不能局所進行食道癌に対する治療成績について検証した．
【対象と方法】2016年から2019年の期間で，当院で治療した切除不能局所進行食道癌9例(リンパ節T4bも含む)を対象とした．
【結果】男性：6例，女性：3例．年齢：中央値 64（41-78）歳．腫瘍主占居部位：Ut/Mt/Lt=1/7/1．浸潤臓器:気管/左主気管支/大動脈=2/4/3，cN0/1/2=1/3/5，初回治療: ICT/CRT=7/2であった．初回治療別に検証すると，奏効率:ICT/CRT=5(71.4%)/0(0%)であり，ICTにて奏効が得られた5例は根治切除可能と判断し，4例（80％）でR0切除が得られた．術後合併症は，縫合不全0例，肺炎1例(20%)，反回神経麻痺2例(40%)であった．術後在院日数中央値は16日(13-21)であった．R0切除4例は全例1年以上の生存が得られているが，2例で再発(リンパ節再発1例，肺・リンパ節再発1例)を認めた．R1切除例はCRTを追加し，術後2年無再発生存中である．根治切除を施行していない4例の初回治療からの1年生存率は25％と予後不良であった．
【結語】切除不能局所進行食道癌であってもICTを組み入れることでconversion surgeryが安全に施行され，高いR0切除率が得られ，予後の延長に寄与する可能性がある．, Background:
Recently, the usefulness of surgical resection after induction chemotherapy (ICT) including Docetaxel / 5-FU / Cisplatin therapy for locally advanced esophageal cancer has been reported. 
Methods:
Nine patients with locally advanced unresectable esophageal cancer who underwent multidisciplinary treatment in our hospital from 2016 to 2019 were eligible for this study. 
Results:
The patients’ characteristics included a median age of 64 years; the male/female ratio of 6/3; Tumor main occupancy site Ut / Mt / Lt = 1/7/1; Invading adjacent organs: trachea / left main bronchus / aorta; 2/4/3, Lymph node metastasis (0/1/2); 1/3/5, and initial treatment ICT / CRT; 7/2. Response rate of ICT were 71.4% (5 cases) and that of CRT were 0%. Four patients (80%) of 5 patients who responded to ICT were underwent R0 resection. Postoperative complications were anastomotic leakage in 0 cases, pneumonia in 1 case (20%), and recurrent nerve paralysis in 2 cases (40%). The median length of hospital stay after surgery was 16 days. All 4 cases of R0 resection had survived for 1 year or more. The 1-year survival rate from the initial treatment of 4 patients who did not undergo radical resection was 25%. 
Conclusion:
Conversion surgery after ICT for locally advanced unresectable esophageal cancer may contribute to a high R0 resection rate and better clinical outcomes., Departmental Bulletin Paper},
 pages = {10--13},
 title = {当院における切除不能局所進行食道癌の治療成績},
 volume = {34},
 year = {2021}
}