局部进展期GEJA综合治疗的现状与思考

胃食管交界部腺癌（gastroesophageal junction adenocarcinoma，GEJA）具有独特的生物学特性和预后，且发病率显著增加，但其诊断和治疗仍存在争议。新辅助治疗和辅助治疗联合手术治疗较单纯手术均可改善局部进展期GEJA患者生存。而新辅助治疗中的新辅助放化疗较新辅助化疗可提高患者手术切除率和局部控制率，改善患者生活质量，联合分子靶向药物可进一步增加疗效。局部进展期GEJA患者的综合治疗数据多来源于食管癌或胃癌的随机临床研究，应开展更多大样本前瞻性随机对照研究，优化新辅助和辅助综合治疗，改善局部进展期GEJA患者的生存。本文对局部进展期GEJA综合治疗的研究进展进行综述。 

Current situation and progress in the comprehensive treatment of locally advanced gastroesophageal junction adenocarcinoma

Based on special biological characteristics and prognosis, the incidence of gastroesophageal junction adenocarcinoma (GEJA) has rapidly increased over recent years, and its diagnosis and treatment remain controversial.Compared with simple surgery, neo-adjuvant and adjuvant therapies can improve the survival of patients with locally advanced GEJA.Under neo-adjuvant therapy, neo-adjuvant chemoradiation is superior to neo-adjuvant chemotherapy alone for improving the resectability, maintaining loco-regional control, and improving the quality of life of the patient.The combination of this therapy with targeted drugs may further increase the efficacy of GEJA.Most data on GEJA-treated patients were obtained from randomized clinical studies on esophageal cancer or gastric cancer.Thus, prospective randomized controlled studies with a large sample size should be performed to optimize the strategy of neo-adjuvant and adjuvant therapies, and further improve the treatment outcome.In this article, studies on the comprehensive treatment of GEJA were reviewed.