术前同步放化疗在食管癌综合治疗中的作用

Role of preoperative chemoradiotherapy in the comprehensive treatment of esophageal cancer

术前同步放化疗在食管癌综合治疗中起到了重要作用.利用放疗与化疗的互补和协同作用,提高局控率,有助于杀灭靶区以外转移病灶内的肿瘤细胞,有益于提高切除率、减少复发、改善预后.但术前同步放化疗也会带来相应的不良反应,如血液学毒性、心脏毒性、放射性肺损伤等,同时也会给手术带来一定的难度,如术中游离肿瘤困难可能性加大、术后并发症风险增加等.本文将重点阐述术前同步放化疗的理论基础、可能机制及其在降低食管癌分期、提高手术切除率及病理缓解率、提高生存率中的作用.同时也将简单阐述术前同步放化疗不良反应的机制和预防.

Preoperative chemoradiotherapy plays an important role in the comprehensive treatment of patients with esophageal cancer.Concurrent administration of radiation and chemotherapy can produce additive or even synergistic effects,improve local control rate,help kill tumor cells in metastatic lesions located outside the target area,raise resection rate,reduce recurrence,and improve prognosis.However,preoperative chemoradiotherapy is also associated with many side effects,such as hematologic toxicity,cardiac toxicity,and radioactive lung damage,and often causes surgical difficulties,such as difficulty in intraoperative tumor manipulation and increased risk of complications.This paper focuses on the theoretical basis and possible mechanisms of preoperative chemoradiotherapy and discusses its role in reducing esophageal cancer stage and improving resection rate,pathologic response rate,and survival rate.We also briefly discuss the pathogenesis and prevention of adverse reactions associated with preoperative chemoradiotherapy.