食管鳞癌新辅助治疗的研究进展与挑战

Research progress and challenges of neoadjuvant therapy for esophageal squamous cell carcinoma

手术是可切除食管鳞癌的主要治疗手段,然而对于局部进展期患者,以手术为主的综合治疗是其最佳治疗策略。一些随机对照临床研究和Meta分析的研究结果表明,新辅助治疗可以提高患者生存率,新辅助治疗包括新辅助化疗、放化疗、靶向治疗和免疫治疗。近年来,食管鳞癌的新辅助治疗虽然取得了长足进步,但仍存在许多亟待解决的临床问题,包括新辅助治疗的疗效和安全性,新辅助治疗方案和治疗周期的选择、最佳组合和多模式治疗的策略以及优势人群的筛选等。本文就目前食管鳞癌新辅助治疗的最新进展和存在的挑战做一综述。

Surgery is the main treatment for resectable esophageal squamous cell carcinoma.However,for patients with locally advanced lesions,surgery⁃based comprehensive treatment is the best treatment strategy.According to the results of some randomized controlled clinical studies and meta⁃analysis,preoperative neoadjuvant therapy is recommended to improve the survival rate of patients.Neoadjuvant therapy includes neoadjuvant chemotherapy,chemoradiotherapy,targeted therapy and immunotherapy.Great progress has been made in neoadjuvant therapy,but there are still many clinical problems that need to be solved urgently,including the efficacy and safety of neoadjuvant therapy,the choice of neoadjuvant regimen and treatment cycle,the best combination and advantages of multimodal treatment,and the selection of responders to treatment,etc.This article provides a systematic review of the latest developments and existing controversies in neoadjuvant therapy for esophageal squamous cell carcinoma.