Cellini Francesco, Morganti Alessio G, Di Matteo Francesco M, Mattiucci Gian Carlo, Valentini Vincenzo
Radiation Oncology, Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00144 Rome, Italy.
Radiat Oncol. 2014 Feb 5;9:45. doi: 10.1186/1748-717X-9-45.
Gastroesophageal cancers (such as esophageal, gastric and gastroesophageal-junction -GEJ- lesions) are worldwide a leading cause of death being relatively rare but highly aggressive. In the past years, a clear shift in the location of upper gastrointestinal tract tumors has been recorded, both affecting the scientific research and the modern clinical practice. The integration of pre- or peri-operative multimodal approaches, as radiotherapy and chemotherapy (often combined), seems promising to further improve clinical outcome for such presentations. In the past, the definition of GEJ led to controversies and confusion: GEJ tumors have been managed either grouped to gastric or esophageal lesions, following slightly different surgical, radiotherapeutic and systemic approaches. Recently, the American Joint Committee on Cancer (AJCC) changed the staging and classification system of GEJ to harmonize some staging issues for esophageal and gastric cancer. This review discusses the most relevant historical and recent evidences of neoadjuvant treatment involving Radiotherapy for GEJ tumors, and describes the efficacy of such treatment in the frame of multimodal integrated therapies, from the new point of view of the recent classification of such tumors.
胃肠道癌症（如食管癌、胃癌和胃食管交界部 -GEJ- 病变）在全球范围内是导致死亡的主要原因之一，虽然相对罕见但侵袭性很强。在过去几年中，上消化道肿瘤的发病部位出现了明显变化，这对科研和现代临床实践都产生了影响。术前或围手术期多模式治疗方法（如放疗和化疗，通常联合使用）的整合，似乎有望进一步改善此类疾病的临床疗效。过去，胃食管交界部的定义存在争议和混淆：胃食管交界部肿瘤的治疗要么归类于胃癌，要么归类于食管癌，采用的手术、放疗和全身治疗方法略有不同。最近，美国癌症联合委员会（AJCC）改变了胃食管交界部的分期和分类系统，以协调食管癌和胃癌的一些分期问题。本综述讨论了涉及胃食管交界部肿瘤放疗的新辅助治疗的最相关历史和最新证据，并从此类肿瘤最新分类的新角度描述了这种治疗在多模式综合治疗框架中的疗效。
