Ono Takashi, Koto Masashi
Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan.
Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
World J Gastrointest Surg. 2025 Jul 27;17(7):106767. doi: 10.4240/wjgs.v17.i7.106767.
Esophageal cancer is one of the most difficult cancers to treat since it is often at an advanced stage at the time of symptom presentation. For locally advanced esophageal cancer, treatment options include multidisciplinary treatment such as surgery or definitive chemoradiotherapy. Surgery has a high local control rate because it involves excision of the cancer along with the surrounding organs; however, it is still highly invasive, although advances in surgery have reduced the burden on patients. On the other hand, chemoradiotherapy may also be applicable in cases in which surgery is inoperable owing to complications or distant lymph node metastasis. However, chemoradiotherapy using X-ray irradiation can cause late toxicities, including those to the heart. Proton beam therapy is widely used to treat esophageal cancer because of its characteristics, and some comparisons between proton beam therapy and X-ray therapy or surgery have recently been reported. This review discusses the role of proton beam therapy in esophageal cancer in comparison to X-ray therapy and surgery.
食管癌是最难治疗的癌症之一，因为在出现症状时往往已处于晚期。对于局部晚期食管癌，治疗选择包括多学科治疗，如手术或根治性放化疗。手术具有较高的局部控制率，因为它涉及切除癌症及周围器官；然而，尽管手术技术的进步减轻了患者的负担，但它仍然具有高度侵袭性。另一方面，对于因并发症或远处淋巴结转移而无法进行手术的病例，放化疗也可能适用。然而，使用X射线照射的放化疗会导致晚期毒性，包括对心脏的毒性。质子束治疗因其特性被广泛用于治疗食管癌，最近有一些关于质子束治疗与X射线治疗或手术之间的比较报道。本综述讨论了质子束治疗与X射线治疗和手术相比在食管癌治疗中的作用。
