摘要
近年来,多学科综合治疗的突破不断涌现,为重新审视当前局部进展期食管鳞癌围手术期治疗模式提供了新机遇。鉴于涉及食管癌分期谱广泛,临床中难以实现异病同治。针对原发肿瘤负荷(T分期较重)的局部治疗抑或转移性淋巴结负荷(N分期较重)的全身治疗,应予以辩证性个体化处理。鉴于当前缺乏实用性强的预测标志物,根据不同肿瘤负荷表型(T/N负荷相对关系),导向性选择不同疗法具有未来临床价值。尽管围手术期应用免疫治疗面临诸多潜在挑战,但这也将有助于促进未来围手术期治疗策略的优化。
Recent advances in multimodality treatment offer excellent opportunities to rethink the paradigm of perioperative management for locally advanced esophageal squamous cell carcinoma.One treatment clearly doesn't fit all in terms of a broad disease spectrum.Individualized treatment of local control of bulky primary tumor burden(advanced T stage)or systemic control of nodal metastatic tumor burden(advanced N stage)is essential.Given that clinically applicable predictive biomarkers are still awaited,therapy selection guided by diverse phenotypes of tumor burden(T vs.N)is promising.Potential challenges regarding the use of immunotherapy may also boost this novel strategy in the future.
作者
康晓征
张瑞祥
王镇
陈先凯
秦建军
李印
薛奇
赫捷
Kang Xiaozheng;Zhang Ruixiang;Wang Zhen;Chen Xiankai;Qin Jianjun;Li Yin;Xue Qi;He Jie(Department of Thoracic Surgery,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《中华胃肠外科杂志》
CSCD
北大核心
2023年第4期334-338,共5页
Chinese Journal of Gastrointestinal Surgery
基金
科技部科技基础资源调查专项基金(2019FY101101)
希思科-朝阳肿瘤研究项目基金(Y-Young2021-0145)。
关键词
食管肿瘤
围手术期
免疫治疗
肿瘤异质性
Esophageal neoplasms
Perioperative
Immunotherapy
Tumor heterogeneity
