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食管癌治疗（成人）(PDQ®)

食管癌的基本信息

食管癌是一种恶性（癌）细胞形成于食管组织的疾病。

食管是中空的肌肉管，可以将食物和液体从咽喉部位运送至胃部。食管壁由多层组织构成，包括黏膜、肌肉和结缔组织。食管癌发生于食管的最内层，并随着病情发展向外层扩散。

食管和胃是上消化道（消化）系统的一部分。

有两种类型的食管癌最为常见，这两种类型的食管癌因其恶性（癌）细胞类型而命名。

  • 鳞状细胞癌：在食管内膜薄而扁平的细胞中形成的癌症。这种癌症常见于食管的中、上段，但可能发生于食管的任何部位。这也被称作表皮样癌。
  • 腺癌：始于腺细胞的癌症。食管内膜的腺细胞产生和分泌液体，例如黏液。腺癌通常发生于食管下段，接近胃的部位。

    • 吸烟、酗酒和Barrett食管可增加食管癌的风险。

    任何可能增加患病风险的因素都被称为风险因素。具备风险因素并不意味着你会患癌症；不具备风险因素也不意味着你不会患癌症。如果你觉得自己可能有患癌风险，请和医生进行沟通。风险因素包括以下内容：

  • 吸烟。
  • 酗酒。
  • Barrett食管：食管下段内膜细胞发生改变或被异常细胞所取代的疾病，这种异常细胞可能导致食管癌。胃反流（胃灼热）是Barrett食管最常见的病因。
  • 高龄

    • 如想了解食管癌预防的更多信息，请见PDQ总结。

    食管癌的症状是体重减轻和吞咽困难或疼痛。

    这些体征和症状既可能是由食管癌引起，也可能是由其他疾病引起。如果出现以下症状，请与医生联系：

  • 吞咽困难或疼痛。
  • 体重下降。
  • 胸骨后疼痛。
  • 嗓音嘶哑和咳嗽。
  • 消化不良和胃灼热。
  • 皮下肿块

    • 检查食管的项目？用来检出（发现）和诊断食管癌。

    可能会用到以下检查和程序：

  • 体格检查和病史：对身体进行检查，以检查一般健康体征，包括疾病的迹象，如肿块或其它的异常。病人健康习惯和过往病史及治疗方法也会参考。
  • x线胸片：胸部内部器官和骨骼的 x 线检查。 x射线是一种能量束，可以穿过身体并投射到胶片上，拍摄身体内部区域的图像。
  • 食管镜检查：这是一种观察食管内部检查异常区域的方法。食管镜经口或鼻插入，并沿咽喉向下伸入食管。食管镜是一种细管状设备，配有灯和观察镜。食管镜还配有可以切除组织样本的工具，医务人员可以在显微镜下检查样本是否有癌症迹象。使用食管镜观察食管和胃部的程序叫做上消化道内镜检查。
    • 食管镜检查。将一根细而发光的管子从口腔插入，伸入食管，检查异常区域。
  • 活检：取出细胞或组织，病理科医生通过显微镜检查癌症迹象。通常在食管镜检查期间进行活检。有时活检可显示非癌，但可能会发展为癌的改变。

    • 影响预后（痊愈机会）和治疗方案的几个因素。

    预后（痊愈机会）和治疗方案取决于以下几个因素：

  • 癌症分期（是否累及部分食管、累及整个食管或已扩散至体内其他部位）。
  • 肿瘤是否可以通过手术完全切除。
  • 患者总体健康情况。

    • 当早期发现食管癌时，痊愈的可能性比较大。食管癌确诊时往往已属晚期。食管癌晚期可以进行治疗但鲜少能被治愈。可以考虑参加改善治疗水平的临床试验。可以通过NCI网站找到目前正在进行的临床试验信息。

    Esophageal Cancer Treatment (Adult) (PDQ®)

    General Information About Esophageal Cancer

    Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus.

    The esophagus is the hollow, muscular tube that moves food and liquid from the throat to the stomach. The wall of the esophagus is made up of several layers of tissue, including mucous membrane, muscle, and connective tissue. Esophageal cancer starts on the inside lining of the esophagus and spreads outward through the other layers as it grows.

    The esophagus and stomach are part of the upper gastrointestinal (digestive) system.

    The two most common forms of esophageal cancer are named for the type of cells that become malignant (cancerous):

  • Squamous cell carcinoma: Cancer that forms in the thin, flat cells lining the inside of the esophagus. This cancer is most often found in the upper and middle part of the esophagus, but can occur anywhere along the esophagus. This is also called epidermoid carcinoma.
  • Adenocarcinoma: Cancer that begins in glandular cells. Glandular cells in the lining of the esophagus produce and release fluids such as mucus. Adenocarcinomas usually form in the lower part of the esophagus, near the stomach.

    • Smoking, heavy alcohol use, and Barrett esophagus can increase the risk of esophageal cancer.

    Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors include the following:

  • Tobacco use.
  • Heavy alcohol use.
  • Barrett esophagus: A condition in which the cells lining the lower part of the esophagus have changed or been replaced with abnormal cells that could lead to cancer of the esophagus. Gastric reflux (heartburn) is the most common cause of Barrett esophagus.
  • Older age.

    • See the PDQ summary on Esophageal Cancer Prevention for more information.

    Signs and symptoms of esophageal cancer are weight loss and painful or difficult swallowing.

    These and other signs and symptoms may be caused by esophageal cancer or by other conditions. Check with your doctor if you have any of the following:

  • Painful or difficult swallowing.
  • Weight loss.
  • Pain behind the breastbone.
  • Hoarseness and cough.
  • Indigestion and heartburn.
  • A lump under the skin.

    • Tests that examine the esophagus are used to detect (find) and diagnose esophageal cancer.

    The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • Esophagoscopy: A procedure to look inside the esophagus to check for abnormal areas. An esophagoscope is inserted through the mouth or nose and down the throat into the esophagus. An esophagoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. When the esophagus and stomach are looked at, it is called an upper endoscopy.
    • Esophagoscopy. A thin, lighted tube is inserted through the mouth and into the esophagus to look for abnormal areas.
  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The biopsy is usually done during an esophagoscopy. Sometimes a biopsy shows changes in the esophagus that are not cancer but may lead to cancer.

    • Certain factors affect prognosis (chance of recovery) and treatment options.

    The prognosis (chance of recovery) and treatment options depend on the following:

  • The stage of the cancer (whether it affects part of the esophagus, involves the whole esophagus, or has spread to other places in the body).
  • Whether the tumor can be completely removed by surgery.
  • The patient’s general health.

    • When esophageal cancer is found very early, there is a better chance of recovery. Esophageal cancer is often in an advanced stage when it is diagnosed. At later stages, esophageal cancer can be treated but rarely can be cured. Taking part in one of the clinical trials being done to improve treatment should be considered. Information about ongoing clinical trials is available from the NCI website.

    食管癌治疗（成人）(PDQ®)

    食管癌分期

    在确诊食管癌后，医护人员会进行检查以确定癌细胞是在食管内扩散还是已扩散至人体其他部位。

    用来确定癌细胞是在食管内部扩散还是已扩散至人体其他部位的程序叫做分期。由分期过程中获得的信息决定了癌症的分期。了解癌症分期对于指定治疗计划十分重要。分期过程中可能会用到以下检查和程序：

  • 超声内镜检查（EUS）：一种将内窥镜插入体内的检查方法——通常通过口腔或直肠。对于食管癌检查，内窥镜是通过口腔插入的。内窥镜是一种细管状的仪器，带有灯和镜头，可进行观察。内窥镜末端的探头用于将高能声波（超声波）从内部组织或器官中反射回来，形成回声。这些回声形成了身体组织的图像，称为声波图。检查时还可以进行活检。这种检查也被称为超声内镜检查。
  • CT扫描（CAT扫描）：从不同角度拍摄身体内部区域（如胸部、腹部和骨盆）而形成一系列详细图像的程序。图片通过连接X光机的电脑绘制出来。患者血管中可能会注入造影剂或患者可能吞咽造影剂，以帮助器官或组织能够更清晰的显现出来。这个过程被称为计算机断层扫描，或计算机断层成像术或计算机轴向断层扫描。
  • PET扫描（正电子发射断层扫描）：这是一种寻找人体内恶性肿瘤细胞的方法。将少量的放射性葡萄糖（糖）注入血管中。PET扫描仪围绕人体旋转，绘制出人体正在利用葡萄糖的那个部位的图片。图片中比较亮的部分是恶性肿瘤细胞，因为恶性肿瘤细胞更加活跃，吸收的葡萄糖比正常细胞多。PET扫描和CT扫描可以同时进行。这就叫做PET-CT.
  • MRI（核磁共振成像）：这是一种利用磁体，无线电波和计算机绘制出人体内部一系列细节图的过程。这个程序被称为核磁共振成像（NMRI）。
  • 胸腔镜检查：这是一种观察胸腔内部器官以检查是否有异常区域的手术方法。医生在两条肋骨之间切一个切口，然后将胸腔镜伸入胸腔。胸腔镜是一种细管状的工具，配有灯和观察镜。胸腔镜还可能配有切除组织或淋巴结样本的工具，这些样本将在显微镜下进行观察以检查癌症迹象。有些情况下，这个方法可能会用来切除部分食管或肺。
  • 腹腔镜检查：这是一种观察腹部内器官以检查癌症是否存在的手术方法。在腹壁上切出（多个）小切口，然后将腹腔镜（轻的细管）伸入其中的一个小切口。其他工具可以通过同一个或其他切口伸入腹腔进行操作，比如切除器官，采集组织样本，在显微镜下检查以寻找癌症迹象。
  • 超声检查：高能声波（超声波）被人体内部组织或器官（如颈部组织或器官）反射回来并产生回声的检查。这些回声形成了人体组织的图像，称为声波图。该图像可以打印出来以后进行查看。

    • 癌细胞在人体内扩散有三种方式。

    癌细胞可以通过组织、淋巴系统和血液扩散：

  • 组织。癌细胞通过从原发部位生长至附近区域进行扩散
  • 淋巴系统。癌细胞通过进入淋巴系统从原发部位扩散。通过淋巴管扩散至身体其他部位。
  • 血液。癌细胞通过进入血液从原发部位扩散。通过血管扩散至身体其他部位。

    • 癌细胞可能会从原发部位扩散至人体其他部位。

    当癌细胞扩散至人体其他部位，这种现象就被称为转移。癌细胞离开发生部位（原发性肿瘤）然后通过淋巴系统和血液扩散。

  • 淋巴系统。癌细胞进入淋巴系统，通过淋巴管扩散，然后在人体其他部位形成肿瘤（转移瘤）。
  • 血液。癌细胞进入血液，通过血管扩散，然后在人体其他部位形成肿瘤（转移瘤）

    • 转移瘤和原发性肿瘤是同一种类型的癌症。比如，如果食管癌扩散至肺部，肺部的癌细胞实际上是食管癌细胞。这样的疾病是转移性食管癌，而不是肺癌。

    许多癌症死亡是由于癌细胞从原发的肿瘤转移、扩散到其他组织和器官。这被称为转移性癌症。这个动画展示了癌细胞是如何从体内最初形成的部位转移到身体的其他部位的。

    肿瘤的分级也用来描述癌症并制定治疗计划。

    肿瘤的分级描述了异常的癌细胞在显微镜下是什么样的，肿瘤生长和扩散的速度有多快。1至3级用来描述食管癌：

  • 1级，癌细胞在显微镜下看起来更像是正常细胞，生长和扩散的速度比2级和3级癌细胞要慢。
  • 2级，与1级癌细胞相比，癌细胞在显微镜下看起来更像是异常细胞，且生长和扩散的速度更快。
  • 3级，癌细胞在显微镜下看起来更像是异常细胞，生长和扩散的速度比1级和2级癌细胞快。

    • 食管鳞状细胞癌分期如下：

    0期（高度异型增生）

    在0期，食管壁内膜已形成癌细胞。0期也称作高度异型增生。

    0期食管鳞状细胞癌。食管壁内膜已形成癌细胞。

    食管鳞状细胞癌 I期

    根据癌细胞扩散的位置，I期可分为IA期和IB期。

  • IA期：癌细胞已扩散到食管壁的固有黏膜层或黏膜肌层。癌细胞为1级，或级别不明。
    • IA期食管鳞状细胞癌。癌细胞已扩散到食管壁的固有黏膜层或黏膜肌层。癌细胞属于1级，或者级别不明。在显微镜下，1级癌细胞看起来更像正常细胞，生长和扩散的速度比2级和3级癌细胞要慢。
  • IB期：癌细胞已经扩散：
  • 侵及食管壁的黏膜层、黏膜肌层或黏膜下层。癌细胞可以是任何级别，或级别不明;或
  • 侵及食管壁的固有肌层。癌细胞属于1级。
    • IB期食管鳞状细胞癌。癌细胞已扩散至食管壁的黏膜层、薄肌层或黏膜下层。癌细胞可以是任何级别，或级别不明；或者癌细胞已经扩散到食管壁的厚肌层。癌细胞属于1级。在显微镜下，1级癌细胞看起来更像正常细胞，生长和扩散的速度比2级和3级癌细胞要慢。

    食管鳞状细胞癌 II期

    根据癌细胞扩散的位置，II期可分为IIA期和IIB期。

  • IIA期：癌细胞已经扩散：
  • 侵及食管壁的厚肌层。癌细胞属于2级或3级，或者级别不明；或
    • IIA期食管鳞状细胞癌(1).癌细胞已扩散至食管壁的厚肌层。癌细胞为2级或3级或者级别不明。在显微镜下，2级和3级癌细胞看起来异常，生长和扩散速度比1级癌细胞更快。
  • 侵及食管壁的结缔组织层。肿瘤位于食管下段；或
    • IIA期食管鳞状细胞癌(2)。癌细胞已扩散至食管壁结缔组织层。肿瘤位于食管下段。
  • 侵及食管壁的结缔组织层。癌细胞属于1级。肿瘤位于食管的上段或中段。
    • IIA期食管鳞状细胞癌(3)，癌细胞已扩散至食管壁结缔组织层。癌细胞属于1级。在显微镜下，1级癌细胞看起来更像正常细胞，生长和扩散的速度比2级和3级癌细胞慢。肿瘤位于食管的上段或中段。
  • IIB期：癌细胞已经扩散：
  • 侵及食管壁的结缔组织层。癌细胞属于2级或3级。肿瘤位于食管的上段或中段;或
    • IIB期食管鳞状细胞癌(1)。癌细胞已扩散至食管壁结缔组织层。癌细胞属于2级或3级。在显微镜下，2级和3级癌细胞看起来异常，生长和扩散速度比1级癌细胞更快。肿瘤位于食管的上段或中段。
  • 侵及食管壁的结缔组织层。癌细胞的级别不明，或者不知道肿瘤在食管的原发部位；或
    • IIB期食管鳞状细胞癌(2)。癌细胞已扩散至食管壁结缔组织层。癌细胞的级别不明，或者不知道肿瘤是在食管的原发部位。
  • 侵及食管壁的黏膜层、薄肌层或黏膜下层。肿瘤附近的1或2个淋巴结发现转移。
    • IIB期食管鳞状细胞癌(3)。癌细胞已扩散到食管壁的黏膜层、薄肌层或黏膜下层。肿瘤附近的1或2个淋巴结发现转移。

    食管鳞状细胞癌 III期

    根据癌细胞扩散的部位，III期可分为IIIA期和IIIB期。

  • IIIA期：癌细胞已经扩散：
  • 侵及食管壁的黏膜层、薄肌层或黏膜下层。肿瘤附近有3至6个淋巴结发现转移；或
  • 侵及食管壁的厚肌层。肿瘤附近有1或2个淋巴结发现转移。
    • IIIA期食管癌鳞状细胞癌。癌细胞已扩散至食管壁的黏膜层、薄肌层或黏膜下层。肿瘤附近有3至6个淋巴结发现转移；或者癌细胞已经扩散到食管壁的厚肌层。肿瘤附近的1至2个淋巴结发现转移。
  • IIIB期：癌细胞已经扩散：
  • 侵及食管壁的厚肌层或结缔组织层。肿瘤附近1至6个淋巴结发现转移；或
    • IIIB期食管鳞状细胞癌(1).癌细胞已扩散至食管壁的厚肌层或结缔组织层。肿瘤附近的1至6个淋巴结中发现转移。
  • 侵及膈肌，奇静脉，胸膜，心包，或腹膜。可在肿瘤附近的0 - 2个淋巴结发现转移。
    • IIIB期食管鳞状细胞癌(2)。癌细胞已扩散至(a)膈肌、(b)奇静脉、(c)胸膜、(d)心包或腹膜(未显示)。肿瘤附近的0 - 2个淋巴结发现转移。

    食管鳞状细胞癌 IV期

    根据癌细胞扩散的位置，IV期分为IVA和IVB期。

  • IVA期：癌细胞已经扩散：
  • 侵及膈肌，奇静脉，胸膜，心包，或腹膜。肿瘤附近的3至6个淋巴结发现转移；或
    • IVA期食管鳞状细胞癌(1)。癌细胞已扩散至(a)膈肌、(b)奇静脉、(c)胸膜、(d)心包或腹膜(未显示)。肿瘤附近的3到6个淋巴结发现转移。
  • 侵及附近的结构，如主动脉、气道或脊柱。肿瘤附近0 至6个淋巴结发现转移；或
    • IVA期食管鳞状细胞癌(2)。癌细胞已扩散到附近的结构，如气道、主动脉或脊柱。肿瘤附近0 至 6个淋巴结发现转移。
  • 到达肿瘤附近的7个或更多的淋巴结。
    • IVA期食管鳞状细胞癌(3)。癌细胞已扩散至肿瘤附近的7个或更多的淋巴结。
  • IVB期:癌细胞已经扩散到人体的其他部位，如肝脏或肺。
    • IVB期食管鳞状细胞癌。癌细胞已扩散到人体的其他部位，如肝脏或肺。

    以下是食管腺癌的分期：

    0期（高度异型增生）

    在0期，癌细胞在食管壁的内膜形成。0期也称作高级别异型增生。

    0期食管腺癌。癌细胞已在食管壁内膜形成。

    食管腺癌I期

    根据癌细胞扩散的部位，I期可分为IA期、IB期和IC期。

  • IA期:肿瘤已扩散到食管壁的黏膜层或薄肌层。癌细胞属于1级，或级别不明。
    • IA期食管腺癌。癌细胞已扩散到食管壁的粘膜层或薄肌层。癌细胞属于1级，或级别不明。在显微镜下，1级癌细胞看起来更像正常细胞，生长和扩散速度比2级和3级癌细胞慢。
  • IB期：癌细胞已经扩散：
  • 侵及食管壁的黏膜层、薄肌层或黏膜下层。癌细胞为2级；或
  • 侵及食管壁黏膜下层。癌细胞为1级或2级，或级别不明。
    • IB期食管腺癌。癌细胞已扩散到食管壁的黏膜层或薄肌层。癌细胞属于2级。在显微镜下，2级癌细胞看起来异常，生长和扩散速度比1级癌细胞更快；或者癌细胞已经扩散到食管壁的黏膜下层。癌细胞属于1级或2级，或者级别不明。
  • IC期：癌细胞已经扩散：
  • 侵及食管壁的黏膜层、薄肌层或黏膜下层。癌细胞为3级；或
  • 侵及食管壁的厚肌层。癌细胞属于1级或2级。
    • IC期食管腺癌。癌细胞已扩散至食管壁的黏膜层、薄肌层或黏膜下层。癌细胞属于3级。在显微镜下，3级癌细胞看起来异常，生长和扩散速度比1级和2级癌细胞更快；或者癌细胞已经扩散到食管壁的厚肌层。癌细胞属于1级或2级。

    食管腺癌II期：

    根据癌细胞扩散的位置，II期可分为IIA期和IIB期。

  • IIA期:癌细胞已扩散至食管壁的厚肌层。癌细胞属于3级，或级别未知。
    • IIA期食管腺癌。癌细胞已扩散到食管壁的厚肌层。癌细胞属于3级，或者级别不明。在显微镜下，3级癌细胞看起来异常，生长和扩散的速度比1级和2级癌细胞更快。
  • IIB期：癌细胞已经扩散
  • 侵及食管壁的结缔组织层；或
  • 侵及食管壁的黏膜层、薄肌层或黏膜下层。肿瘤附近的1或2个淋巴结发现转移。
    • IIB期食管腺癌。癌细胞已经扩散到食管壁的结缔组织层；或者癌细胞已经扩散到食管壁的黏膜层、薄肌层或者黏膜下层。肿瘤附近的1至2个淋巴结发现转移。

    食管腺癌 III期：

    根据癌细胞扩散的部位，III期可分为IIIA期和IIIB期。

  • IIIA期：癌细胞已经扩散：
  • 侵及食管壁的黏膜层、薄肌层或黏膜下层。肿瘤附近的3至6个淋巴结发现转移；或
  • 侵及食管壁的厚肌层。肿瘤附近的1或2个淋巴结发现转移。
    • IIIA期食管腺癌。癌细胞已扩散至食管壁的黏膜层、薄肌层或黏膜下层。肿瘤附近的3至6个淋巴结发现转移；或者癌细胞已经扩散到食管壁的厚肌层。肿瘤附近的1至2个淋巴结发现转移。
  • IIIB期：癌细胞已经扩散：
  • 侵及食管壁的厚肌层。肿瘤附近的3至6个淋巴结发现转移；或
  • 侵及食管壁的结缔组织层。肿瘤附近的1至6个淋巴结发现转移；或
    • IIIB期食管腺癌(1)。癌细胞已扩散至食管壁的厚肌层。肿瘤附近的3至6个淋巴结发现转移；或者癌细胞已经扩散到食管壁的结缔组织层。肿瘤附近的1至6个淋巴结发现转移。
  • 侵及膈肌、奇静脉、胸膜、心包或腹膜。肿瘤附近的0 - 2个淋巴结发现转移。
    • IIIB期食管腺癌(2)。癌细胞已扩散至(a)膈肌、(b)奇静脉、(c)胸膜、(d)心包或腹膜(未显示)。肿瘤附近的0 - 2个淋巴结发现转移。

    食管腺癌IV期：

    根据癌细胞扩散的位置，IV期可分为IVA期和IVB期。

  • IVA期：癌细胞已经扩散：
  • 侵及膈肌、奇静脉、胸膜、心包或腹膜。肿瘤附近的3至6个淋巴结发现转移；或
    • IVA期食管腺癌(1)。肿瘤已扩散至(a)膈肌、(b)奇静脉、(c)胸膜、(d)心包或腹膜(未显示)。肿瘤附近的3到6个淋巴结发现转移。
  • 侵及附近的结构，如主动脉、气道或脊柱。肿瘤附近的0 - 6个淋巴结发现转移；或
    • IVA期食管腺癌(2)。癌细胞已扩散到附近的结构，例如气道、主动脉或脊柱。肿瘤附近的0 - 6个淋巴结发现转移。
  • 到达肿瘤附近的7或更多个淋巴结。
    • IVA期食管腺癌(3)。癌细胞已扩散至肿瘤附近的7个或更多个淋巴结。
  • IVB期：癌细胞已经扩散到人体的其他部位，如肝脏或肺。
    • IVB期食管腺癌。癌细胞已扩散到人体的其他部位，如肝脏或肺。
    Esophageal Cancer Treatment (Adult) (PDQ®)

    Stages of Esophageal Cancer

    After esophageal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the esophagus or to other parts of the body.

    The process used to find out if cancer cells have spread within the esophagus or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

  • Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body, usually through the mouth or rectum. For esophageal cancer, the endoscope is inserted through the mouth. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. A biopsy may also be done. This procedure is also called endosonography.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, abdomen, and pelvis, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. A PET scan and CT scan may be done at the same time. This is called a PET-CT.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • Thoracoscopy: A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure may be used to remove part of the esophagus or lung.
  • Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples to be checked under a microscope for signs of disease.
  • Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs, such as those in the neck, and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.

    • There are three ways that cancer spreads in the body.

    Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

    • Cancer may spread from where it began to other parts of the body.

    When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

  • Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.

    • The metastatic tumor is the same type of cancer as the primary tumor. For example, if esophageal cancer spreads to the lung, the cancer cells in the lung are actually esophageal cancer cells. The disease is metastatic esophageal cancer, not lung cancer.

    Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.

    The grade of the tumor is also used to describe the cancer and plan treatment.

    The grade of the tumor describes how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grades 1 to 3 are used to describe esophageal cancer:

  • In grade 1, the cancer cells look more like normal cells under a microscope and grow and spread more slowly than grade 2 and 3 cancer cells.
  • In grade 2, the cancer cells look more abnormal under a microscope and grow and spread more quickly than grade 1 cancer cells.
  • In grade 3, the cancer cells look more abnormal under a microscope and grow and spread more quickly than grade 1 and 2 cancer cells.

    • The following stages are used for squamous cell carcinoma of the esophagus:

    Stage 0 (High-grade Dysplasia)

    In stage 0, cancer has formed in the inner lining of the esophagus wall. Stage 0 is also called high-grade dysplasia.

    Stage 0 squamous cell carcinoma of the esophagus. Cancer has formed in the inner lining of the esophagus wall.

    Stage I squamous cell carcinoma of the esophagus

    Stage I is divided into stages IA and IB, depending on where the cancer has spread.

  • Stage IA: Cancer has spread into the mucosa layer or thin muscle layer of the esophagus wall. The cancer cells are grade 1 or the grade is not known.
    • Stage IA squamous cell carcinoma of the esophagus. Cancer has spread into the mucosa layer or thin muscle layer of the esophagus wall. The cancer cells are grade 1 or the grade is not known. Grade 1 cancer cells look more like normal cells under a microscope and grow and spread more slowly than grade 2 and 3 cancer cells.
  • Stage IB: Cancer has spread:
  • into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. The cancer cells are any grade or the grade is not known; or
  • into the thick muscle layer of the esophagus wall. The cancer cells are grade 1.
    • Stage IB squamous cell carcinoma of the esophagus. Cancer has spread into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. The cancer cells are any grade or the grade is not known; OR cancer has spread into the thick muscle layer of the esophagus wall. The cancer cells are grade 1. Grade 1 cancer cells look more like normal cells under a microscope and grow and spread more slowly than grade 2 and 3 cancer cells.

    Stage II squamous cell carcinoma of the esophagus

    Stage II is divided into stages IIA and IIB, depending on where the cancer has spread.

  • Stage IIA: Cancer has spread:
  • into the thick muscle layer of the esophagus wall. The cancer cells are grade 2 or 3 or the grade is not known; or
    • Stage IIA squamous cell carcinoma of the esophagus (1). Cancer has spread into the thick muscle layer of the esophagus wall. The cancer cells are grade 2 or 3 or the grade is not known. Grade 2 and 3 cancer cells look more abnormal under a microscope and grow and spread more quickly than grade 1 cancer cells.
  • into the connective tissue layer of the esophagus wall. The tumor is in the lower esophagus; or
    • Stage IIA squamous cell carcinoma of the esophagus (2). Cancer has spread into the connective tissue layer of the esophagus wall. The tumor is in the lower esophagus.
  • into the connective tissue layer of the esophagus wall. The cancer cells are grade 1. The tumor is in either the upper or middle esophagus.
    • Stage IIA squamous cell carcinoma of the esophagus (3). Cancer has spread into the connective tissue layer of the esophagus wall. The cancer cells are grade 1. Grade 1 cancer cells look more like normal cells under a microscope and grow and spread more slowly than grade 2 and 3 cancer cells. The tumor is in either the upper or middle esophagus.
  • Stage IIB: Cancer has spread:
  • into the connective tissue layer of the esophagus wall. The cancer cells are grade 2 or 3. The tumor is in either the upper or middle esophagus; or
    • Stage IIB squamous cell carcinoma of the esophagus (1). Cancer has spread into the connective tissue layer of the esophagus wall. The cancer cells are grade 2 or 3. Grade 2 and 3 cancer cells look more abnormal under a microscope and grow and spread more quickly than grade 1 cancer cells. The tumor is in either the upper or middle esophagus.
  • into the connective tissue layer of the esophagus wall. The grade of the cancer cells is not known, or it is not known where the tumor has formed in the esophagus; or
    • Stage IIB squamous cell carcinoma of the esophagus (2). Cancer has spread into the connective tissue layer of the esophagus wall. The grade of the cancer cells is not known, or it is not known where the tumor has formed in the esophagus.
  • into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. Cancer is found in 1 or 2 lymph nodes near the tumor.
    • Stage IIB squamous cell carcinoma of the esophagus (3). Cancer has spread into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. Cancer is found in 1 to 2 lymph nodes near the tumor.

    Stage III squamous cell carcinoma of the esophagus

    Stage III is divided into stages IIIA and IIIB, depending on where the cancer has spread.

  • Stage IIIA: Cancer has spread:
  • into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. Cancer is found in 3 to 6 lymph nodes near the tumor; or
  • into the thick muscle layer of the esophagus wall. Cancer is found in 1 or 2 lymph nodes near the tumor.
    • Stage IIIA squamous cell carcinoma of the esophagus. Cancer has spread into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. Cancer is found in 3 to 6 lymph nodes near the tumor; OR cancer has spread into the thick muscle layer of the esophagus wall. Cancer is found in 1 to 2 lymph nodes near the tumor.
  • Stage IIIB: Cancer has spread:
  • into the thick muscle layer or the connective tissue layer of the esophagus wall. Cancer is found in 1 to 6 lymph nodes near the tumor; or
    • Stage IIIB squamous cell carcinoma of the esophagus (1). Cancer has spread into the thick muscle layer or the connective tissue layer of the esophagus wall. Cancer is found in 1 to 6 lymph nodes near the tumor.
  • into the diaphragm, azygos vein, pleura, sac around the heart, or peritoneum. Cancer may be found in 0 to 2 lymph nodes near the tumor.
    • Stage IIIB squamous cell carcinoma of the esophagus (2). Cancer has spread into the (a) diaphragm, (b) azygos vein, (c) pleura, (d) sac around the heart, or peritoneum (not shown). Cancer may be found in 0 to 2 lymph nodes near the tumor.

    Stage IV squamous cell carcinoma of the esophagus

    Stage IV is divided into stages IVA and IVB, depending on where the cancer has spread.

  • Stage IVA: Cancer has spread:
  • into the diaphragm, azygos vein, pleura, sac around the heart, or peritoneum. Cancer is found in 3 to 6 lymph nodes near the tumor; or
    • Stage IVA squamous cell carcinoma of the esophagus (1). Cancer has spread into the (a) diaphragm, (b) azygos vein, (c) pleura, (d) sac around the heart, or peritoneum (not shown). Cancer is found in 3 to 6 lymph nodes near the tumor.
  • into nearby structures, such as the aorta, airway, or spine. Cancer may be found in 0 to 6 lymph nodes near the tumor; or
    • Stage IVA squamous cell carcinoma of the esophagus (2). Cancer has spread into nearby structures, such as the airway, aorta, or spine. Cancer may be found in 0 to 6 lymph nodes near the tumor.
  • to 7 or more lymph nodes near the tumor.
    • Stage IVA squamous cell carcinoma of the esophagus (3). Cancer has spread to 7 or more lymph nodes near the tumor.
  • Stage IVB: Cancer has spread to other parts of the body, such as the liver or lung.
    • Stage IVB squamous cell carcinoma of the esophagus. Cancer has spread to other parts of the body, such as the liver or lung.

    The following stages are used for adenocarcinoma of the esophagus:

    Stage 0 (High-grade Dysplasia)

    In stage 0, cancer has formed in the inner lining of the esophagus wall. Stage 0 is also called high-grade dysplasia.

    Stage 0 adenocarcinoma of the esophagus. Cancer has formed in the inner lining of the esophagus wall.

    Stage I adenocarcinoma of the esophagus

    Stage I is divided into stages IA, IB, and IC, depending on where the cancer has spread.

  • Stage IA: Cancer has spread into the mucosa layer or thin muscle layer of the esophagus wall. The cancer cells are grade 1 or the grade is not known.
    • Stage IA adenocarcinoma of the esophagus. Cancer has spread into the mucosa layer or thin muscle layer of the esophagus wall. The cancer cells are grade 1 or the grade is not known. Grade 1 cancer cells look more like normal cells under a microscope and grow and spread more slowly than grade 2 and 3 cancer cells.
  • Stage IB: Cancer has spread:
  • into the mucosa layer or thin muscle layer of the esophagus wall. The cancer cells are grade 2; or
  • into the submucosa layer of the esophagus wall. The cancer cells are grade 1 or 2 or the grade is not known.
    • Stage IB adenocarcinoma of the esophagus. Cancer has spread into the mucosa layer or thin muscle layer of the esophagus wall. The cancer cells are grade 2. Grade 2 cancer cells look more abnormal under a microscope and grow and spread more quickly than grade 1 cancer cells; OR cancer has spread into the submucosa layer of the esophagus wall. The cancer cells are grade 1 or 2 or the grade is not known.
  • Stage IC: Cancer has spread:
  • into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. The cancer cells are grade 3; or
  • into the thick muscle layer of the esophagus wall. The cancer cells are grade 1 or 2.
    • Stage IC adenocarcinoma of the esophagus. Cancer has spread into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. The cancer cells are grade 3. Grade 3 cancer cells look more abnormal under a microscope and grow and spread more quickly than grade 1 and 2 cancer cells; OR cancer has spread into the thick muscle layer of the esophagus wall. The cancer cells are grade 1 or 2.

    Stage II adenocarcinoma of the esophagus

    Stage II is divided into stages IIA and IIB, depending on where the cancer has spread.

  • Stage IIA: Cancer has spread into the thick muscle layer of the esophagus wall. The cancer cells are grade 3 or the grade is not known.
    • Stage IIA adenocarcinoma of the esophagus. Cancer has spread into the thick muscle layer of the esophagus wall. The cancer cells are grade 3 or the grade is not known. Grade 3 cancer cells look more abnormal under a microscope and grow and spread more quickly than grade 1 and 2 cancer cells.
  • Stage IIB: Cancer has spread:
  • into the connective tissue layer of the esophagus wall; or
  • into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. Cancer is found in 1 or 2 lymph nodes near the tumor.
    • Stage IIB adenocarcinoma of the esophagus. Cancer has spread into the connective tissue layer of the esophagus wall; OR cancer has spread into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. Cancer is found in 1 to 2 lymph nodes near the tumor.

    Stage III adenocarcinoma of the esophagus

    Stage III is divided into stages IIIA and IIIB, depending on where the cancer has spread.

  • Stage IIIA: Cancer has spread:
  • into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. Cancer is found in 3 to 6 lymph nodes near the tumor; or
  • into the thick muscle layer of the esophagus wall. Cancer is found in 1 or 2 lymph nodes near the tumor.
    • Stage IIIA adenocarcinoma of the esophagus. Cancer has spread into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. Cancer is found in 3 to 6 lymph nodes near the tumor; OR cancer has spread into the thick muscle layer of the esophagus wall. Cancer is found in 1 to 2 lymph nodes near the tumor.
  • Stage IIIB: Cancer has spread:
  • into the thick muscle layer of the esophagus wall. Cancer is found in 3 to 6 lymph nodes near the tumor; or
  • into the connective tissue layer of the esophagus wall. Cancer is found in 1 to 6 lymph nodes near the tumor; or
    • Stage IIIB adenocarcinoma of the esophagus (1). Cancer has spread into the thick muscle layer of the esophagus wall. Cancer is found in 3 to 6 lymph nodes near the tumor; OR cancer has spread into the connective tissue layer of the esophagus wall. Cancer is found in 1 to 6 lymph nodes near the tumor.
  • into the diaphragm, azygos vein, pleura, sac around the heart, or peritoneum. Cancer may be found in 0 to 2 lymph nodes near the tumor.
    • Stage IIIB adenocarcinoma of the esophagus (2). Cancer has spread into the (a) diaphragm, (b) azygos vein, (c) pleura, (d) sac around the heart, or peritoneum (not shown). Cancer may be found in 0 to 2 lymph nodes near the tumor.

    Stage IV adenocarcinoma of the esophagus

    Stage IV is divided into stages IVA and IVB, depending on where the cancer has spread.

  • Stage IVA: Cancer has spread:
  • into the diaphragm, azygos vein, pleura, sac around the heart, or peritoneum. Cancer is found in 3 to 6 lymph nodes near the tumor; or
    • Stage IVA adenocarcinoma of the esophagus (1). Cancer has spread into the (a) diaphragm, (b) azygos vein, (c) pleura, (d) sac around the heart, or peritoneum (not shown). Cancer is found in 3 to 6 lymph nodes near the tumor.
  • into nearby structures, such as the aorta, airway, or spine. Cancer may be found in 0 to 6 lymph nodes near the tumor; or
    • Stage IVA adenocarcinoma of the esophagus (2). Cancer has spread into nearby structures, such as the airway, aorta, or spine. Cancer may be found in 0 to 6 lymph nodes near the tumor.
  • to 7 or more lymph nodes near the tumor.
    • Stage IVA adenocarcinoma of the esophagus (3). Cancer has spread to 7 or more lymph nodes near the tumor.
  • Stage IVB: Cancer has spread to other parts of the body, such as the liver or lung.
    • Stage IVB adenocarcinoma of the esophagus. Cancer has spread to other parts of the body, such as the liver or lung.
    食管癌治疗（成人）(PDQ®)

    复发性食管癌

    复发性食管癌是在经过治疗后再次出现（复发）的癌症。这种癌症可能出现在食管，也可能出现在人体其他部位。

    Esophageal Cancer Treatment (Adult) (PDQ®)

    Recurrent Esophageal Cancer

    Recurrent esophageal cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the esophagus or in other parts of the body.

    食管癌治疗（成人）(PDQ®)

    治疗方法综述

    对于患有食管癌的患者，我们有不同的治疗方法。

    患有食管癌的患者可以选择不同的治疗方法。有些治疗方法是标准的（目前使用的治疗方法），有些则正处于临床试验阶段。关于治疗方法的临床试验是旨在提升目前治疗手段或为癌症患者获取新疗法信息的研究。当临床试验显示新疗法优于标准疗法时，新疗法可能就会变成标准疗法。患者可以考虑参加临床试验。有些临床试验仅对尚未进行治疗的病人开放。

    在治疗食管癌期间，患者有特殊的营养需求。

    因为在吞咽方面有问题，许多食管癌患者觉得吃东西困难。食管可能会因为肿瘤或者治疗的副作用而变窄。有些患者可能会直接通过静脉接受营养。有些患者可能需要饲管（可以通过鼻子或者口腔进入胃部的软塑料管），直到自己能进食。

    目前应用的六种标准治疗方法：

    手术

    食管癌最常见的治疗方法是手术。术中食管的一部分可能被切除，这称为食管切除术。

    食管切除术。切除部分食管，将胃上提并与剩余食管连接。

    医生将会把剩余的健康食管与胃部连接在一起，这样患者就可以进行吞咽。塑料管或者肠的一部分可能会用作连接。食管附近的淋巴结可能也会被切除，并在显微镜下进行检查，观察淋巴结是否含有癌细胞转移。如果食管被肿瘤部分阻塞，可能会将自膨式金属支架（管）放置在食管中，保持食管处于通畅状态。

    食管支架。在食管中放置一个装置（支架）以保持食管处于通畅状态，使食物和液体能够通过食管进入胃中。

    早期的小肿瘤和高度异型增生可在内镜下切除。内窥镜(一种细管状仪器，带有灯和镜头，可进行观察)可通过皮肤上的小切口或人体的开口(如口腔)插入。内窥镜上连接的工具用于切除组织。

    放射治疗

    放射疗法是一种使用高能x射线或其他类型的辐射杀死癌细胞或抑制癌细胞生长的癌症治疗方法。有两种类型的放射治疗方法:

  • 体外放射疗法是利用体外的机器将射线发送到癌症部位。
  • 体内放射疗法是将放射性物质密封在针、植入粒子、导丝或导管中，然后直接放置到肿瘤病灶或附近。

    • 采用的放射治疗方式取决于癌症的类型和分期。体外和体内放射疗法均可用于治疗食管癌。

    在放射治疗过程中，可能会在食管中插入塑料导管以保持食管处于通畅状态。这叫做腔内插管和扩张。

    化疗

    化疗是通过使用药物杀死癌细胞或阻止癌细胞分裂，从而阻止癌细胞生长的疗法。如果从口服药物进行化疗，或者通过静脉注射或肌肉注射药物进行化疗，药物就会进入血液并能通过全身（全身化疗）到达癌细胞。当将化疗药物直接置于脑脊液、器官或者体腔内，比如腹腔，药物主要会影响这些部位的癌细胞（区域化疗）。化疗的方式取决于癌症的类型和阶段。

    欲了解更多信息，请见批准的治疗食管癌的药物。

    放化疗

    放化疗是结合化疗和放射疗法以增加二者治疗效果的疗法。

    激光治疗

    激光治疗是使用激光束（极窄的强光束）以杀死癌细胞的疗法。

    电凝术

    电凝术是使用电流杀死癌细胞的疗法。

    临床试验正在测试的新型疗法。

    这个总结部分描述了临床试验中正在研究的治疗方法。这里可能不会提到正在研究的每一种新疗法。有关临床试验的信息可从NCI网站网站查询。

    靶向治疗

    靶向治疗是一种利用药物或其他物质来识别和攻击特定癌细胞的治疗方法。与化疗和放疗相比，靶向治疗通常对正常细胞的伤害较小。单克隆抗体治疗是一种治疗食管癌的靶向治疗方法。

    单克隆抗体疗法利用一类从实验室里的某种免疫系统细胞中获得的抗体进行治疗。这些抗体可以识别癌细胞上的物质或能够促进癌细胞生长的正常物质。抗体附着在这些物质上，杀死癌细胞，抑制癌细胞生长，或抑制癌细胞扩散。单克隆抗体通过注射给药。它们可以单独使用，也可以直接将药物、毒素或放射性物质运送到癌细胞。曲妥珠单抗是一种正在研究的治疗食管癌的单克隆抗体。它可以阻断生长因子蛋白HER2的作用——HER2可以向食管癌细胞传递生长信号。

    食管癌的治疗可能会产生副作用。

    有关癌症治疗的副作用的信息，请参阅我们的副作用页面。

    患者可能想要参与临床试验中。

    对于某些患者来说，参与临床试验可能是最佳的治疗选择。临床试验是癌症研究过程的一部分。进行临床试验的目的就是为了了解新型癌症疗法是否安全有效，或是否优于标准疗法。

    目前许多标准疗法都是基于早前的临床试验的。参与临床试验的患者可能会接受标准疗法治疗，也可能成为第一批接受新型疗法的人。

    参与临床试验的患者还可以帮助改善未来治疗癌症的方式。即便是临床试验没有在有效新疗法上取得进展，临床试验也通常能解答重要问题并帮助研究不断推进。

    患者可以在开始癌症治疗前、中、后参与临床试验。

    有些临床试验仅对尚未接受治疗的患者进行研究。有些临床试验针对病情尚未好转的病人进行研究。还有一些临床试验对防止癌症复发（再次出现） 或减少癌症治疗的副作用的新方法进行测试。

    临床试验正在全国许多地方进行。有关NCI支持的临床试验的信息可在NCI的临床试验搜索网页上找到。其他组织支持的临床试验可在ClinicalTrials.gov网站上找到。

    可能会需要随访检查

    有些为了诊断癌症或者确定癌症分期的检查可能会重复进行。有些检查会重复进行以观察疗法的效果。是否继续、改变或者停止治疗的决定可能会基于这些检查结果。

    有时候，在治疗结束后，这些检查仍会继续进行。这些检查结果会显示你的情况是否发生变化，或癌症是否已经复发（重新出现）。有时，这些检查被称为随访检查。

    Esophageal Cancer Treatment (Adult) (PDQ®)

    Treatment Option Overview

    There are different types of treatment for patients with esophageal cancer.

    Different types of treatment are available for patients with esophageal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Patients have special nutritional needs during treatment for esophageal cancer.

    Many people with esophageal cancer find it hard to eat because they have trouble swallowing. The esophagus may be narrowed by the tumor or as a side effect of treatment. Some patients may receive nutrients directly into a vein. Others may need a feeding tube (a flexible plastic tube that is passed through the nose or mouth into the stomach) until they are able to eat on their own.

    Six types of standard treatment are used:

    Surgery

    Surgery is the most common treatment for cancer of the esophagus. Part of the esophagus may be removed in an operation called an esophagectomy.

    Esophagectomy. A portion of the esophagus is removed and the stomach is pulled up and joined to the remaining esophagus.

    The doctor will connect the remaining healthy part of the esophagus to the stomach so the patient can still swallow. A plastic tube or part of the intestine may be used to make the connection. Lymph nodes near the esophagus may also be removed and viewed under a microscope to see if they contain cancer. If the esophagus is partly blocked by the tumor, an expandable metal stent (tube) may be placed inside the esophagus to help keep it open.

    Esophageal stent. A device (stent) is placed in the esophagus to keep it open to allow food and liquids to pass through into the stomach.

    Small, early-stage cancer and high-grade dysplasia of the esophagus may be removed by endoscopic resection. An endoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted through a small incision (cut) in the skin or through an opening in the body, such as the mouth. A tool attached to the endoscope is used to remove tissue.

    Radiation therapy

    Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:

  • External radiation therapy uses a machine outside the body to send radiation toward the cancer.
  • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

    • The way the radiation therapy is given depends on the type and stage of the cancer being treated. External and internal radiation therapy are used to treat esophageal cancer.

    A plastic tube may be inserted into the esophagus to keep it open during radiation therapy. This is called intraluminal intubation and dilation.

    Chemotherapy

    Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

    See Drugs Approved for Esophageal Cancer for more information.

    Chemoradiation therapy

    Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both.

    Laser therapy

    Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells.

    Electrocoagulation

    Electrocoagulation is the use of an electric current to kill cancer cells.

    New types of treatment are being tested in clinical trials.

    This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website.

    Targeted therapy

    Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do. Monoclonal antibody therapy is a type of targeted therapy used in the treatment of esophageal cancer.

    Monoclonal antibody therapy uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Trastuzumab is a monoclonal antibody being studied in esophageal cancer. It may be given to block the effect of the growth factor protein HER2, which sends growth signals to esophageal cancer cells.

    Treatment for esophageal cancer may cause side effects.

    For information about side effects caused by treatment for cancer, see our Side Effects page.

    Patients may want to think about taking part in a clinical trial.

    For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

    Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

    Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

    Patients can enter clinical trials before, during, or after starting their cancer treatment.

    Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

    Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

    Follow-up tests may be needed.

    Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

    Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

    食管癌治疗（成人）(PDQ®)

    根据分期选择治疗方案

    欲了解下列治疗方法的信息，请见治疗方案概述部分。

    0期（高度异型增生）

    0期食管癌的治疗包括以下方法：

  • 手术
  • 内镜切除

    • 使用我们的临床试验搜索引擎，您可以查找在NCI支持的癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的基本信息。

    I期食管癌

    I期食管鳞状细胞癌或腺癌的治疗可能包括以下内容：

  • 术前放化疗联合手术
  • 单纯手术

    • 使用我们的临床试验搜索引擎，您可以查找在NCI支持的癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的基本信息。

    II期食管癌

    II期食管鳞状细胞癌或腺癌的治疗可能包括以下内容：

  • 术前放化疗联合手术
  • 单纯手术
  • 术前化疗联合手术
  • 单纯放化疗治疗

    • 使用我们的临床试验搜索引擎，您可以查找在NCI支持的癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的基本信息。

    III期食管癌

    III期食管鳞状细胞癌或腺癌的治疗可能包括以下内容：

  • 术前放化疗联合手术
  • 术前化疗联合手术
  • 单纯放化疗治疗

    • 使用我们的临床试验搜索引擎，您可以查找在NCI支持的癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的基本信息。

    IV期食管癌

    IV期食管鳞状细胞癌或腺癌的治疗可能包括以下内容：

  • 术前放化疗联合手术
  • 化疗。
  • 姑息性治疗；进行激光手术或电凝术，以缓解症状，提高生活质量。
  • 姑息性治疗；植入食管镜支架，以缓解症状，提高生活质量。
  • 姑息性治疗：进行外部或内部放射治疗，以缓解症状，提高生活质量。
  • 化疗临床试验。
  • 靶向治疗联合化疗的临床试验。

    • 使用我们的临床试验搜索引擎，您可以查找在NCI支持的癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的基本信息。

    Esophageal Cancer Treatment (Adult) (PDQ®)

    Treatment Options By Stage

    For information about the treatments listed below, see the Treatment Option Overview section.

    Stage 0 (High-grade Dysplasia)

    Treatment of stage 0 may include the following:

  • Surgery.
  • Endoscopic resection.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage I Esophageal Cancer

    Treatment of stage I esophageal squamous cell carcinoma or adenocarcinoma may include the following:

  • Chemoradiation therapy followed by surgery.
  • Surgery alone.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage II Esophageal Cancer

    Treatment of stage II esophageal squamous cell carcinoma or adenocarcinoma may include the following:

  • Chemoradiation therapy followed by surgery.
  • Surgery alone.
  • Chemotherapy followed by surgery.
  • Chemoradiation therapy alone.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage III Esophageal Cancer

    Treatment of stage III esophageal squamous cell carcinoma or adenocarcinoma may include the following:

  • Chemoradiation therapy followed by surgery.
  • Chemotherapy followed by surgery.
  • Chemoradiation therapy alone.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage IV Esophageal Cancer

    Treatment of stage IV esophageal squamous cell carcinoma or adenocarcinoma may include the following:

  • Chemoradiation therapy followed by surgery.
  • Chemotherapy.
  • Laser surgery or electrocoagulation as palliative therapy to relieve symptoms and improve quality of life.
  • An esophageal stent as palliative therapy to relieve symptoms and improve quality of life.
  • External or internal radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
  • Clinical trials of chemotherapy.
  • A clinical trial of targeted therapy combined with chemotherapy.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    食管癌治疗（成人）(PDQ®)

    复发性食管癌的治疗选择

    欲了解下列治疗方法的信息，请见治疗方案概述部分。

    复发性食管癌的治疗可能包括以下内容：

  • 姑息性治疗：使用任意标准疗法以缓解症状，提高生活质量。
  • 临床试验

    • 使用我们的临床试验搜索引擎，您可以查找在NCI支持的癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的基本信息。

    Esophageal Cancer Treatment (Adult) (PDQ®)

    Treatment Options for Recurrent Esophageal Cancer

    For information about the treatments listed below, see the Treatment Option Overview section.

    Treatment of recurrent esophageal cancer may include the following:

  • Use of any standard treatments as palliative therapy to relieve symptoms and improve quality of life.
  • Clinical trials.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    食管癌治疗（成人）(PDQ®)

    了解更多关于食管癌的知识

    想要从国立癌症研究所了解更多关于食管癌的信息，请见以下内容：

  • 食管癌主页
  • 食管癌预防
  • 食管癌筛查
  • 儿童食管癌治疗
  • 胃肠道间质瘤治疗（成人）
  • 癌症治疗中的营养
  • 化疗和头颈部放疗的口腔并发症
  • 吸烟（包括戒烟的好处）
  • 癌症治疗中的激光技术

    • 想了解更多一般癌症信息和国立癌症研究所的其他资源，请见以下内容：

  • 关于癌症
  • 分期
  • 化疗和你：支持患癌人群
  • 放射治疗和你：支持患癌人群
  • 战胜癌症
  • 你应该向医生咨询的关于癌症的问题
  • 幸存者和护理者
    • Esophageal Cancer Treatment (Adult) (PDQ®)

    To Learn More About Esophageal Cancer

    For more information from the National Cancer Institute about esophageal cancer, see the following:

  • Esophageal Cancer Home Page
  • Esophageal Cancer Prevention
  • Esophageal Cancer Screening
  • Childhood Esophageal Cancer Treatment
  • Gastrointestinal Stromal Tumors Treatment (Adult)
  • Nutrition in Cancer Care
  • Oral Complications of Chemotherapy and Head/Neck Radiation
  • Tobacco (includes help with quitting)
  • Lasers in Cancer Treatment

    • For general cancer information and other resources from the National Cancer Institute, see the following:

  • About Cancer
  • Staging
  • Chemotherapy and You: Support for People With Cancer
  • Radiation Therapy and You: Support for People With Cancer
  • Coping with Cancer
  • Questions to Ask Your Doctor about Cancer
  • For Survivors and Caregivers
    • 食管癌治疗（成人）(PDQ®)

    About This PDQ Summary

    About PDQ

    Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

    PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

    Purpose of This Summary

    This PDQ cancer information summary has current information about the treatment of adult esophageal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

    Reviewers and Updates

    Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

    The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

    Clinical Trial Information

    A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

    Permission to Use This Summary

    PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

    The best way to cite this PDQ summary is:

    PDQ® Adult Treatment Editorial Board. PDQ Esophageal Cancer Treatment (Adult). Bethesda, MD: National Cancer Institute. Updated . Available at: https://www.cancer.gov/types/esophageal/patient/esophageal-treatment-pdq. Accessed . [PMID: 26389463]

    Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

    Disclaimer

    The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

    Contact Us

    More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

    Esophageal Cancer Treatment (Adult) (PDQ®)

    About This PDQ Summary

    About PDQ

    Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

    PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

    Purpose of This Summary

    This PDQ cancer information summary has current information about the treatment of adult esophageal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

    Reviewers and Updates

    Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

    The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

    Clinical Trial Information

    A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

    Permission to Use This Summary

    PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

    The best way to cite this PDQ summary is:

    PDQ® Adult Treatment Editorial Board. PDQ Esophageal Cancer Treatment (Adult). Bethesda, MD: National Cancer Institute. Updated . Available at: https://www.cancer.gov/types/esophageal/patient/esophageal-treatment-pdq. Accessed . [PMID: 26389463]

    Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

    Disclaimer

    The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

    Contact Us

    More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

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    目录
    章 节
    食管癌的基本信息 食管癌分期 复发性食管癌 治疗方法综述 根据分期选择治疗方案 复发性食管癌的治疗选择 了解更多关于食管癌的知识 About This PDQ Summary
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