Huang Runkai, Qiu Zhenbin, Zheng Chunwen, Zeng Ruijie, Chen Wanxian, Wang Simeng, Li Enmin, Xu Yiwei
Department of Biochemistry and Molecular Biology, Shantou University Medical College, Shantou, China.
Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, China.
Front Oncol. 2022 Apr 7;12:734581. doi: 10.3389/fonc.2022.734581. eCollection 2022.
Esophageal carcinoma is one of the most aggressive malignant diseases. At present, neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy are regarded as the standard modalities for the treatments of locally advanced esophageal cancers based on several landmark trials. However, the optimal regimen, radiation dose, and surgical intervals are uncertain and the rate of recurrence after neoadjuvant therapy is high. Patients receiving neoadjuvant therapy and reaching a pathological complete response have been reported to have a better survival benefit and a fewer recurrence risk than those non-pathological complete responses. Nevertheless, less than half of patients will reach a pathological complete response after neoadjuvant therapy, and the methods to evaluate the efficacy after neoadjuvant therapy accurately are limited. Immune checkpoint inhibitors have been recommended for the treatments of advanced esophageal cancers. Recently, research has been beginning to evaluate the safety and efficacy of immunotherapy combined with neoadjuvant therapy. Here, we will review and discuss the development of the neoadjuvant therapy of locally advanced esophageal cancers and unsolved clinical problems.
食管癌是最具侵袭性的恶性疾病之一。目前，基于多项具有里程碑意义的试验，新辅助化疗和新辅助放化疗被视为局部晚期食管癌治疗的标准模式。然而，最佳方案、放疗剂量和手术间隔尚不确定，新辅助治疗后的复发率很高。据报道，接受新辅助治疗并达到病理完全缓解的患者比未达到病理完全缓解的患者具有更好的生存获益和更低的复发风险。尽管如此，新辅助治疗后不到一半的患者会达到病理完全缓解，且准确评估新辅助治疗后疗效的方法有限。免疫检查点抑制剂已被推荐用于晚期食管癌的治疗。最近，研究开始评估免疫治疗联合新辅助治疗的安全性和疗效。在此，我们将回顾和讨论局部晚期食管癌新辅助治疗的进展及尚未解决的临床问题。
