晚期食管癌的放射治疗策略

Radiotherapy strategy for advanced esophageal cancer

晚期食管癌在所有食管癌病例中占有很大的比例,目前指南推荐的治疗模式为系统治疗。放疗作为恶性肿瘤的重要治疗手段,临床应用广泛。回顾性分析和小样本前瞻性研究显示,在晚期食管癌治疗中,放疗与化疗、靶向治疗、免疫治疗联合均有提高疾病控制率、改善症状和延长生存时间的优势。因此,更好地发挥放疗对食管癌的快速起效、持久控制和激发新抗原等方面的优势是重要的临床课题。本文就如何优化晚期食管癌的治疗策略,综述了寡转移性食管癌、多发转移性食管癌的放疗策略及放疗适宜人群的筛选方法,为提升放疗在晚期食管癌综合治疗中的地位提供参考。

Advanced esophageal cancer accounts for a large proportion of all esophageal cancer cases,and the treatment modality recommended by the current guidelines is systemic treatment.Radiotherapy is an important treatment option for malignant tumors,which is widely applied in clinical practice.Retrospective analysis and small-sample prospective studies have shown that combination of radiotherapy with chemotherapy,targeted therapy,and immunotherapy has the advantages of improving disease control rate,symptom remission rate and prolonging survival of advanced esophageal cancer patients.Therefore,it is an important clinical topic issue to make better use of the advantages of radiotherapy for esophageal cancer,such as rapid relief of symptoms,durable efficacy,and stimulation of immune neoantigens,etc.To optimize the treatment strategy of advanced esophageal cancer,the radiotherapy strategy for esophageal cancer with oligometastases or multiple metastases,and the screening method for the eligible population for radiotherapy were reviewed,aiming to provide reference for improving the status of radiotherapy in comprehensive treatment of advanced esophageal cancer.