晚期食管鳞状细胞癌一线免疫治疗联合化疗进展后的诊疗策略——四川省专家共识

doi:10.3760/cma.j.cn371439-20241203-00047

摘要/Abstract

摘要：

中国食管癌疾病负担居全球首位，发病率地区差异显著。四川省作为食管癌高发地区，面临更加复杂严峻的现状。晚期食管鳞状细胞癌一线免疫治疗联合化疗临床应用广泛，但免疫耐药后疾病进展的治疗尚无统一标准和共识，各级医院的治疗方案相对杂乱。鉴于此，四川省抗癌协会食管癌专业委员会组织省内食管癌研究领域的多学科专家，参考国内外指南、共识和最新循证医学研究证据，结合临床实践经验，共同制订了本共识，以期为临床医师提供科学、规范的指导，进一步提高晚期食管鳞状细胞癌患者的治疗效果和生命质量，推动四川省食管癌诊疗水平的提升。

关键词: 食道鳞癌, 免疫检查点抑制剂, 抗药性, 疾病恶化, 治疗策略, 专家共识

Abstract:

The disease burden of esophageal cancer in China ranks first in the world， with significant regional differences in incidence. Sichuan province is facing a more complicated and severe situation， with a high incidence of esophageal cancer. Although first-line immunotherapy combined with chemotherapy for advanced esophageal squamous cell carcinoma has been widely used clinically， but there is no unified standard and consensus on the treatment of disease progression after immune resistance. The treatment strategy of city-level hospitals is somewhat disordered. In light of this， the Esophageal Cancer Professional Committee of the Sichuan Anti-Cancer Association， in conjunction with multidisciplinary experts in the field of esophageal cancer research in Sichuan province， has developed this consensus. The consensus refers to domestic and foreign guidelines， consensus， and the latest evidence-based clinical evidence， combined with clinical practice experience， with the aim of providing scientific and standardized guidance for clinicians. It is hoped to further improve the treatment outcomes and quality of life for patients with advanced esophageal squamous cell carcinoma and promote the advancement of esophageal cancer diagnosis and treatment in Sichuan province.

Key words: Esophageal squamous cell carcinoma, Immune checkpoint inhibitors, Drug resistance, Disease progression, Treatment strategy, Expert consensus

四川省抗癌协会食管癌专业委员会. 晚期食管鳞状细胞癌一线免疫治疗联合化疗进展后的诊疗策略——四川省专家共识[J]. 国际肿瘤学杂志, 2025, 52(5): 273-281.

Esophageal Cancer Professional Committee of the Sichuan Anti-Cancer Association. Expert consensus on the diagnosis and treatment strategies for advanced esophageal squamous cell carcinoma following progression on first-line immunochemotherapy in Sichuan Province[J]. Journal of International Oncology, 2025, 52(5): 273-281.

图/表 2

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证据水平	定义
Ⅰ	至少1项方法学质量良好（产生偏倚可能性小）的大规模随机对照试验或对多项没有非均一性且良好实施随机试验的Meta分析提供的证据
Ⅱ	小规模随机试验或怀疑有偏倚（方法学质量较差）的大规模随机试验，或对这些试验或多项有非均一性的试验的Meta分析
Ⅲ	前瞻性队列研究
Ⅳ	回顾性队列研究或病例对照研究
Ⅴ	没有对照组的研究、病理报告、专家观点