Zhang Minsi, Wu Abraham J
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Chin Clin Oncol. 2017 Oct;6(5):45. doi: 10.21037/cco.2017.06.33.
Radiotherapy plays a crucial role in the curative management of localized esophageal cancer, both as definitive and preoperative therapy. For definitive therapy, the standard radiation dose is 50.4 Gy in 28 fractions and should be delivered with concurrent chemotherapy. Chemoradiotherapy also has a wellestablished benefit in the preoperative setting, as established in the CROSS randomized trial. Radiation fields are typically generous, to account for subclinical extension of disease along the esophagus and to regional nodes. Three-dimensional conformal radiation is the current standard technique for esophageal cancer, though intensity-modulated radiation therapy is increasingly utilized and may improve the outcomes of esophageal radiotherapy by reducing radiation dose to critical normal tissues.
放射治疗在局限性食管癌的治愈性治疗中起着至关重要的作用，无论是作为根治性治疗还是术前治疗。对于根治性治疗，标准放疗剂量为50.4 Gy，分28次给予，且应与同步化疗联合进行。如CROSS随机试验所示，放化疗在术前治疗中也有明确的益处。放疗野通常较大，以考虑疾病沿食管的亚临床扩展及区域淋巴结转移。三维适形放疗是目前食管癌的标准技术，尽管调强放疗的应用越来越多，且可能通过降低对关键正常组织的辐射剂量来改善食管癌放疗的效果。
