Boer Laura Sophie, Nierkens Stefan, Weusten Bas L A M
Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht 3584 CX, Utrecht, Netherlands.
Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein 3435 CM, Utrecht, Netherlands.
World J Gastrointest Oncol. 2025 May 15;17(5):103746. doi: 10.4251/wjgo.v17.i5.103746.
Cryotherapy is a treatment modality that uses extreme cold to destroy unwanted tissue through both immediate and delayed cellular injury. This therapy is increasingly being adopted across various medical specialties due to its minimally invasive nature and technological advancements that have been made. In the esophagus, cryotherapy is particularly utilized for the management of Barrett esophagus. It has been demonstrated to be effective and safe with potential benefits, such as a reduction in pain, over radiofrequency ablation. Additionally, it might offer a valuable alternative for patients unresponsive to radiofrequency ablation. Cryotherapy is applied for other conditions as well, including esophageal squamous cell neoplasia and malignant dysphagia. More research is needed to gain understanding of the utility in these conditions. Interestingly, cryotherapy has shown the ability to enhance the host's immune response in reaction to antigens left after treatment. While preclinical data have demonstrated promising results, the immune response is often insufficient to induce tumor regression in the clinical setting. Therefore, there is growing interest in the combination of cryotherapy and immunotherapy where ablation creates an antigen depot, and the immune system is subsequently stimulated. This combination holds promise for the future and potentially opens new doors for a breakthrough in cancer treatment.
冷冻疗法是一种治疗方式，它利用极寒通过即时和延迟的细胞损伤来破坏不需要的组织。由于其微创性质和已取得的技术进步，这种疗法在各个医学专科中越来越多地被采用。在食管方面，冷冻疗法特别用于巴雷特食管的治疗。已证明它与射频消融相比是有效且安全的，具有潜在益处，如减轻疼痛。此外，它可能为对射频消融无反应的患者提供一种有价值的替代方案。冷冻疗法也用于其他病症，包括食管鳞状细胞瘤和恶性吞咽困难。需要更多研究来了解其在这些病症中的效用。有趣的是，冷冻疗法已显示出能够增强宿主对治疗后留下的抗原的免疫反应。虽然临床前数据已显示出有前景的结果，但在临床环境中免疫反应往往不足以诱导肿瘤消退。因此，人们对冷冻疗法与免疫疗法的联合越来越感兴趣，其中消融产生抗原库，随后刺激免疫系统。这种联合有望在未来取得突破，并可能为癌症治疗开辟新的途径。
