Ahmad M Usman, Javadi Christopher, Poultsides George A
Section of Surgical Oncology, Department of Surgery, Stanford University, Stanford, CA 94205, USA.
Cancers (Basel). 2022 Mar 30;14(7):1755. doi: 10.3390/cancers14071755.
Neoadjuvant treatment strategies for resectable proximal gastric, gastroesophageal junction (GEJ), and distal esophageal cancer have evolved over several decades. Treatment recommendations differ based on histologic type-squamous cell carcinoma (SCC) versus adenocarcinoma (AC)-as well as the exact location of the tumor. Recent and older clinical trials in this area were critically reviewed. Neoadjuvant chemoradiation with concurrent taxane- or fluoropyrimidine-based chemotherapy has an established role for both AC and SCC of the distal esophagus and GEJ. The use of perioperative chemotherapy for gastric AC is based on the FLOT4 and MAGIC trials; however, the utility of neoadjuvant chemoradiation in this setting requires further evaluation. Additional clinical trials evaluating chemotherapy, targeted therapy, immunotherapy, and radiation that are currently in process are highlighted, given the need for further disease control.
几十年来，可切除的近端胃癌、胃食管交界（GEJ）癌和远端食管癌的新辅助治疗策略不断发展。治疗建议因组织学类型（鳞状细胞癌[SCC]与腺癌[AC]）以及肿瘤的确切位置而异。对该领域近期和早期的临床试验进行了严格审查。新辅助放化疗联合基于紫杉烷或氟嘧啶的化疗对远端食管和GEJ的AC和SCC均有既定作用。围手术期化疗用于胃AC是基于FLOT4和MAGIC试验；然而，在这种情况下新辅助放化疗的效用需要进一步评估。鉴于需要进一步控制疾病，重点介绍了目前正在进行的评估化疗、靶向治疗、免疫治疗和放疗的其他临床试验。
