国际肿瘤学杂志 ›› 2023, Vol. 50 ›› Issue (12): 745-750.doi: 10.3760/cma.j.cn371439-20230828-00140

• 综述 • 上一篇    下一篇

局部晚期可手术食管癌经新辅助放化疗达临床完全缓解后的处理策略

巩合义1, 伊艳2,3, 张健1, 李宝生2()   

  1. 1山东第一医科大学附属中心医院肿瘤科,济南 250013
    2山东省肿瘤防治研究院 山东第一医科大学附属肿瘤医院放疗科 山东省放射肿瘤学重点实验室,济南 250117
    3天津医科大学肿瘤医院 国家肿瘤临床医学研究中心 天津市肿瘤防治重点实验室 天津市恶性肿瘤临床医学研究中心,天津 300060
  • 收稿日期:2023-08-28 修回日期:2023-09-19 出版日期:2023-12-08 发布日期:2024-01-16
  • 通讯作者: 李宝生 E-mail:baoshli1963@163.com
  • 基金资助:
    山东省自然科学基金(ZR2022ZD31)

Management strategies for locally advanced operable esophageal carcinoma achieving clinical complete response after neoadjuvant chemoradiotherapy

Gong Heyi1, Yi Yan2,3, Zhang Jian1, Li Baosheng2()   

  1. 1Department of Oncology, Affiliated Central Hospital of Shandong First Medical University, Jinan 250013, China
    2Department of Radiation Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong First Medical University, Shandong Provincial Key Laboratory of Radiation Oncology, Jinan 250117, China
    3Cancer Hospital of Tianjin Medical University, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Treatment, Tianjin Clinical Research Center for Cancer, Tianjin 300060, China
  • Received:2023-08-28 Revised:2023-09-19 Online:2023-12-08 Published:2024-01-16
  • Contact: Li Baosheng E-mail:baoshli1963@163.com
  • Supported by:
    Natural Science Foundation of Shandong Province of China(ZR2022ZD31)

摘要:

局部晚期可手术食管癌的标准治疗模式是新辅助放化疗+根治性食管切除术,但鉴于器官保留的临床需求,经新辅助放化疗达临床完全缓解后的处理策略包括等待观察(免手术)、延迟性或挽救性手术、加强系统治疗等,这些处理策略在保证患者局部控制和长期生存的基础上,可显著改善其生命质量。深入探讨这些处理策略的可行性、临床价值,期望为这部分患者提供新的治疗思路。

关键词: 食管肿瘤, 放化疗,辅助, 等待观察, 挽救性手术, 系统治疗

Abstract:

The standard treatment mode for locally advanced operable esophageal carcinoma is neoadjuvant chemoradiotherapy combined with radical esophagectomy. However, considering the clinical need for organ retention, the treatment strategies for those achieving complete clinical response after neoadjuvant chemoradiotherapy include watchful waiting (omitting surgery), delayed or salvage surgery, and strengthened systemic treatment. These treatment strategies can significantly improve the quality of patients' life while ensuring local control and long-term survival. The feasibility and clinical value of these treatment strategies are deeply explored, hoping to provide new treatment ideas for this group of patients.

Key words: Esophageal neoplasms, Chemoradiotherapy, adjuvant, Wait and see, Salvage surgery, Systemic therapy