食管癌根治性放疗剂量研究进展

同步放化疗是不可手术局部晚期食管癌的标准治疗模式,国际推荐根治性放疗剂量为50.0~50.4 Gy,但中国食管癌与西方国家在病理类型、生物学行为等方面大有不同,行根治性放疗剂量仍倾向于60 Gy。增加放疗剂量能否带来生存获益成为临床亟待解决的问题。有研究认为高剂量放疗可提高局控率、改善生存,但也有研究认为提高剂量未能带来生存获益,且可增加不良反应事件发生率。因此,本文就食管癌根治性放疗剂量对预后的影响进行探讨,并通过放化疗后疗效评估对放疗剂量做出适当调整,以期达个体化放疗。

Research progress on radical radiation dose for esophageal carcinoma

Concurrent chemoradiotherapy is widely accepted as the standard treatment for locally advanced inoperable esophageal cancer, and 50.0 to 50.4Gy is recommended as the optimal dose for definitive treatment by the international guidelines. However, esophageal cancer in China is quite different from that in western countries in terms of the pathological type and biological characteristics, and a radiation dose of 60Gy is recommended. Whether dose-escalated radiotherapy could bring survival benefits remains to be urgently resolved. Some scholars indicate that the higher radiation dose is correlated with better local tumor control and more favorable survival outcomes, whereas others hold the view that increased toxicity and no survival benefits have been observed in the high dose arm. Therefore, this review is to evaluate the impact caused by different radiation doses and assess the clinical efficacy, aiming to individualize the radiation dose.