Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77005, USA.
Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77005, USA.
Surg Oncol Clin N Am. 2020 Oct;29(4):631-646. doi: 10.1016/j.soc.2020.06.003. Epub 2020 Jul 21.
Management of locally advanced esophageal cancer is evolving. Trimodality therapy with chemoradiation followed by surgical resection has become the standard of care. However, the value of planned surgery after response to therapy is in question. In this article, we discuss the current practice principles and evidence for the treatment of locally advanced esophageal cancer. Topics will include various neoadjuvant therapies, trimodality versus bimodality therapy, and outcomes for salvage esophagectomies. In addition, emerging novel therapies, such as HER2 inhibitors and immunotherapy, are available for unresectable or metastatic disease, enabling a greater armamentarium of tumor biology-specific treatments.
局部晚期食管癌的治疗方法正在不断发展。放化疗联合手术切除的三联疗法已成为标准治疗方法。然而,治疗后计划性手术的价值仍存在争议。本文讨论了局部晚期食管癌治疗的当前实践原则和证据。讨论的主题将包括各种新辅助治疗、三联疗法与二联疗法以及挽救性食管切除术的结果。此外,针对不可切除或转移性疾病,新兴的新型治疗方法,如 HER2 抑制剂和免疫疗法,也可用于治疗,为肿瘤生物学特异性治疗提供了更多的手段。