Han Dan, Li Baosheng, Zhao Qian, Sun Hongfu, Dong Jinling, Hao Shaoyu, Huang Wei
Shandong University Cancer Center, Jinan, China.
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Front Oncol. 2022 Jul 14;12:890688. doi: 10.3389/fonc.2022.890688. eCollection 2022.
Over 50% of individuals with esophageal cancer (EC) present with advanced stages of the disease; therefore, their outcome following surgery alone is poor, with only 25%-36% being alive 5 years post-surgery. Based on the evidence that the CROSS and NEOCRTEC5010 trials provided, neoadjuvant chemoradiotherapy (nCRT) is now the standard therapy for patients with locally advanced EC. However, there are still many concerning clinical questions that remain controversial such as radiation dose, appropriate patient selection, the design of the radiation field, the time interval between chemoradiotherapy (CRT) and surgery, and esophageal retention. With immune checkpoint inhibitors (ICIs) rapidly becoming a mainstay of cancer therapy, along with radiation, chemotherapy, and surgery, the combination mode of immunotherapy is also becoming a hot topic of discussion. Here, we try to provide constructive suggestions to answer the perplexing problems and clinical concerns for the progress of nCRT for EC in the future.
超过50%的食管癌（EC）患者就诊时已处于疾病晚期；因此，仅接受手术治疗的患者预后较差，术后5年生存率仅为25%-36%。基于CROSS和NEOCRTEC5010试验所提供的证据，新辅助放化疗（nCRT）现已成为局部晚期EC患者的标准治疗方法。然而，仍有许多备受关注的临床问题存在争议，如辐射剂量、合适的患者选择、辐射野的设计、放化疗（CRT）与手术之间的时间间隔以及食管潴留等。随着免疫检查点抑制剂（ICI）迅速成为癌症治疗的主要手段之一，与放疗、化疗和手术一起，免疫治疗的联合模式也正成为一个热门的讨论话题。在此，我们试图提供建设性建议，以解答未来EC的nCRT进展中令人困惑的问题和临床关切。
