摘要
食管癌具有独特的解剖学特征和生物学行为,因此综合治疗中的各个手段在疾病的不同阶段均可能发挥重要作用。放射治疗(以下简称放疗)是食管癌的主要治疗手段之一。随着研究的深入,以及设备和技术的进步,除了可切除局部晚期食管癌的术前放疗、术后辅助放疗以及不可切除食管癌的根治性放疗等标准治疗模式之外,放疗在当前的综合治疗模式下逐渐展现出更多的作用,机制也日趋复杂。本文将就食管癌综合治疗中放疗作用的相关进展进行综述,主要按照不同分期展开,包括放疗在早期食管癌中与内镜下治疗联合应用;在可切除局部晚期食管癌中,放疗与免疫治疗联合用于新辅助治疗的研究,并且在器官保留方面进行了根治性放疗加挽救治疗的初步探索;以及放疗在复发/转移性食管癌中也显示出良好的治疗潜力等内容。今后,应基于更加紧密的多学科协作,结合新理念、新技术,进一步提高食管癌精准放疗的个体化水平。
In view of the special anatomical features and biological behavior of esophageal cancer,different means of comprehensive treatment can play an important role in each stage of this disease.Radiotherapy is a mainstay among treatments of esophageal cancer.With the deepening of research and the advances of equipment and technology,radiotherapy has played more roles in the current comprehensive treatments with increasingly complex mechanism,in addition to the standard treatment modalities such as neoadjuvant radiotherapy,adjuvant radiotherapy for resectable locally advanced esophageal cancer,and definitive radiotherapy for unresectable locally advanced esophageal cancer.This article will review the progress related to the participation of radiotherapy in comprehensive treatment by different stages of esophageal cancer,including radiotherapy combined with endoscopic therapies used for early-stage esophageal cancer;for locally advanced resectable esophageal cancer,the investigations involved radiotherapy and immunotherapy for neoadjuvant therapy,and a preliminary exploration of organ-preservation by definitive radiotherapy plus salvage treatment;and in recurrent/metastatic esophageal cancer,a good potential for therapeutic applications achieved with radiotherapy.In the future,based on more closely multidisciplinary collaboration,the new concept and new technology should be integrated into precision radiotherapy for further development of individualized treatment in esophageal cancer.
作者
杨家璇
高麟芮
肖泽芬
刘文扬
Yang Jiaxuan;Gao Linrui;Xiao Zefen;Liu Wenyang(Department of Radiation Oncology,National Cancer Center/National Clinical Research Center For Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《肿瘤综合治疗电子杂志》
2023年第2期1-10,共10页
Journal of Multidisciplinary Cancer Management(Electronic Version)
基金
中国癌症基金会北京希望马拉松专项基金(LC2016L04,LC2022A16)。
关键词
食管癌
新辅助治疗
挽救治疗
器官保留
多学科综合治疗
放射治疗
Esophageal carcinoma
Neoadjuvant therapy
Salvage treatment
Organ preservation
Multi-disciplinary treatment
Radiotherapy
