复发转移食管鳞状细胞癌治疗进展

doi:10.3760/cma.j.cn371439-20210924-00150

摘要/Abstract

摘要：

复发转移食管鳞状细胞癌(ESCC)预后差,治疗选择有限。以铂类为基础联合氟尿嘧啶或紫杉醇类的化疗为其标准一线治疗方案。以西妥昔单抗、帕尼单抗、尼妥珠单抗和吉非替尼等表皮生长因子受体抑制剂为主的分子靶向治疗药物,均未能改善晚期ESCC患者的生存。多靶点小分子酪氨酸激酶抑制剂安罗替尼应用于二线以上治疗可延长患者的中位无进展生存期。相较于化疗,免疫检查点抑制剂(如纳武利尤单抗、帕博利珠单抗、卡瑞利珠单抗)可显著延长一线化疗失败ESCC患者的总生存期,可作为标准二线治疗的选择。免疫治疗联合化疗或抗血管生成治疗应用于晚期ESCC一线治疗的研究也正在进行中。

关键词: 食管肿瘤, 复发, 肿瘤转移, 药物疗法

Abstract:

Relapse or metastatic esophageal squamous cell carcinoma (ESCC) has poor prognosis and limited treatment options. Chemotherapy based on platinum agents combined with fluorouracil or taxanes is the standard first-line treatment for it. Molecular-targeting agents, mainly epidermal growth factor receptor inhibitors including cetuximab, panitumumab, nimotuzumab and gefitinib, have failed to improve the survival of patients with advanced ESCC. Anlotinib, one of the small molecule multi-target tyrosine kinase inhibitors, can prolong the median progression free survival in patients treated with above the second line. Compared with chemotherapy, immune checkpoint inhibitors (including nivolumab, pembrolizumab and camrelizumab) significant improve overall survival times in patients with ESCC who fail to the first line chemotherapy, and can be selected as the standard second line treatment. Immunotherapy combined with chemotherapy or anti-angiogenic therapy for first-line treatment of advanced ESCC is also being studied.

Key words: Esophageal neoplasms, Recurrence, Neoplasm metastasis, Drug therapy

池秀盈, 王鸿彪, 李植锋, 林英城. 复发转移食管鳞状细胞癌治疗进展[J]. 国际肿瘤学杂志, 2021, 48(12): 755-759.

Chi Xiuying, Wang Hongbiao, Li Zhifeng, Lin Yingcheng. Progression in the therapies of relapse or metastatic esophageal squamous cell carcinoma[J]. Journal of International Oncology, 2021, 48(12): 755-759.

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