食管胃结合部腺癌的临床研究热点

Clinical research hotspots on adenocarcinoma of esophagogastric junction

尽管近年来食管胃结合部腺癌（AEG）在发达国家的发病率呈逐渐上升趋势，对于进展期AEG，如何选择最佳治疗方案仍然充满争议。手术是可切除AEG的主要治疗手段，根据不同的Siewert分型选择不同的手术方式，但单纯手术治疗的效果仍无法令人满意。多学科综合治疗可改善AEG患者的生存情况，但在具体治疗模式的选择上不同地区之间存在较大差异。如围术期化疗已成为多数欧洲国家的标准治疗，术前同步放化疗在美国更被医师推崇。今后还需要更多具有针对性的研究来确定AEG的最佳治疗方案，以及化疗、放疗配合手术序贯治疗的最优流程，并进一步明确靶向治疗在可切除AEG中的作用。

Despite increasing incidence of adenocarcinoma of esophagogastric junction （AEG） in developed countries, the optimal therapeutic approach for locally advanced disease remains controversial. Surgery is still the primary treatment for resectable AEG, surgical strategies of AEG are selected according to Siewert classification, but outcomes are dismal with surgery alone. Although multidisciplinary therapy can improve the survival of patients, there is a significant difference in the specific practices among the different regions. Perioperative chemotherapy is the standard method in most European countries, whereas preoperative chemoradiotherapy is favored in the United States. Further studies focusing on AEG are needed to determine the optimal therapeutic strategy and the ideal sequence of chemotherapy and radiation with respect to surgery, and to clarify the role of emerging targeted therapies in resectable AEG.