新辅助免疫联合化疗治疗在局部晚期食管鳞状细胞癌中的研究进展

Recent Advances in Combination of Immunotherapy and Chemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma

食管癌具有死亡率高、预后差等特点。超过三分之一的患者被诊断为局部晚期癌症。食管鳞状细胞癌(ESCC)是亚洲和东欧食管癌的主要组织学亚型。虽然新辅助或最终放化疗(CRT)已成为局部晚期食管鳞状细胞癌的标准治疗方法,但患者的预后仍然不理想,复发率高达30%~50%。免疫检查点抑制剂(ICI)与化学联合治疗食管鳞状细胞癌已成为一种新策略,可能具有协同作用并提供更高的疗效。一些I期和II期研究表明,ICIs联合同步化疗可能会增加可切除食管鳞状细胞癌的病理完全缓解率,但缺乏长期随访结果。在这篇综述中,我们将描述新辅助免疫联合化学治疗局部晚期食管鳞状细胞癌的基本原理和治疗历程。

Esophageal cancer has a high mortality rate and a poor prognosis, with more than one-third of pa-tients receiving a diagnosis of locally advanced cancer. Esophageal squamous cell carcinoma (ESCC) is the dominant histological subtype of esophageal cancer in Asia and Eastern Europe. Although neoadjuvant or definitive chemoradiotherapy (CRT) has been the standard treatment for locally advanced ESCC, patient outcomes remain unsatisfactory, with recurrence rates as high as 30%~50%. The combination of immune checkpoint inhibitors (ICIs) and CRT has emerged as a novel strategy to treat esophageal cancer, and it may have a synergistic action and provide greater efficacy. Moreover, several phase I and II studies have shown that ICIs combined with chemothera-py may increase the rate of pathologic complete response for resectable ESCC, but they lack long-term follow-up results. In this review, we will describe the basic principles and treatment pro-cess of neoadjuvant immunotherapy combined with chemotherapy for locally advanced esophageal squamous cell carcinoma.