局部进展期食管癌新辅助治疗研究进展

术前新辅助治疗是近年来局部进展期食管癌治疗领域的研究热点,越来越多的证据显示新辅助治疗联合手术较单纯手术治疗能明显改善局部进展期食管癌患者的生存,其中新辅助化疗和新辅助放化疗的重要作用已逐步达成共识,并纳入指南推荐。对于局部进展期食管癌,尤其是对于食管腺癌,新辅助化疗和新辅助放化疗都较单纯手术显著改善了患者的生存。两者相比,放疗的参与能否给患者带来更多的获益仍是当前研究的热点。此外,学者一般认为手术在新辅助治疗结束后的2-8周进行,但具体间隔多长时间更为合理,尚无统一定论。本文将就近年来关于局部进展期食管癌术前新辅助治疗的研究进展和存在的问题综述如下。

Research progress in neoadjuvant treatment of locally advanced esophageal cancer

Preoperative neoadjuvant therapy has become a hot topic in the treatment of locally advanced esophageal cancer (EC) in recent years. Accumulated evidences have demonstrated that neoadjuvant therapy combined with surgery could significantly improve the survival of patients with locally advanced EC compared with the surgery alone. The importance of neoadjuvant chemotherapy (nCT) and neoadjuvant chemoradiotherapy (nCRT) has been widely recognized and included in the guidelines. For locally advanced EC, especially for esophageal adenocarcinoma, both nCT and nCRT can significantly prolong the survival of patients than the surgery alone. Currently, whether the supplement of radiotherapy can bring more benefits to patients compared with nCT alone remains a hot topic. Besides, it is generally believed that the operation should be performed at 2-8 weeks after neoadjuvant therapy, whereas the optimal time interval remains debated. In this article, the research progress and existing problems in the preoperative neoadjuvant treatment of locally advanced EC were summarized.