Department of Oncology, First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434000, P.R. China.
Department of Clinical Medicine, Medical School of Yangtze University, Jingzhou, Hubei 434000, P.R. China.
Oncol Rep. 2024 May;51(5). doi: 10.3892/or.2024.8724. Epub 2024 Mar 8.
Definitive concurrent chemoradiotherapy has been the main standard treatment method for unresectable locally advanced esophageal squamous cell cancer (ESCC) since 1999. However, several disadvantages continue to be associated with this type of treatment, including a high local failure rate (reaching ~50% within 3 years) and a median overall survival (OS) time of 16.9 months. In addition, the 5‑year overall survival rate of patients remains relatively low, at only ~21% for patients with ESCC with TNM stage T1‑3N0‑1M0. Burgeoning clinical trials and continually updating treatment modalities are currently in the process of being developed for the treatment of unresectable locally advanced ESCC. Compared with definitive concurrent chemoradiotherapy alone, clinical trials that have examined the efficacy of induction therapy, consolidation therapy, immunotherapy and targeted therapy have observed a prolonged median progression‑free survival and OS. Salvage surgery can also bring benefits to some patients. Therefore, the present review aimed to provide a comprehensive overview on the latest progress that is being made in the development of treatment strategies for unresectable locally advanced ESCC, taking into account the several new challenges that need to be overcome.
自 1999 年以来，确定性同步放化疗一直是不可切除的局部晚期食管鳞癌（ESCC）的主要标准治疗方法。然而，这种治疗方法仍存在一些缺点，包括局部失败率高（3 年内约为 50%）和中位总生存期（OS）为 16.9 个月。此外，ESCC 患者的 5 年总生存率仍然相对较低，仅为 TNM 分期 T1-3N0-1M0 的患者约为 21%。目前正在开展大量临床试验并不断更新治疗方式，以治疗不可切除的局部晚期 ESCC。与单纯确定性同步放化疗相比，诱导治疗、巩固治疗、免疫治疗和靶向治疗的临床试验观察到中位无进展生存期和 OS 延长。挽救性手术也能给一些患者带来获益。因此，本综述旨在全面概述不可切除的局部晚期 ESCC 治疗策略的最新进展，并考虑到需要克服的一些新挑战。
