食管癌新辅助免疫治疗的研究进展综述

Review of Research Progress in Neoadjuvant Immunotherapy for Esophageal Cancer

摘要: 食管癌是全球第六大癌症死亡原因，严重威胁着人类健康。在我国，大多数的食管恶性肿瘤病理组织学类型为鳞癌。由于大多数食管恶性肿瘤患者被诊断时已经处于晚期或转移状态，传统治疗(包括手术、化疗和放疗)的疗效有限，导致食管癌治疗效果上仍未令人满意，食管恶性肿瘤的5年生存率仍有很大的提高空间，这也迫切的需要我们探索新的治疗方法。现如今以PD-1/PDL-1为代表的新辅助免疫治疗联合化疗的方案，已显示出治疗食管癌的潜力，新辅助免疫治疗联合化疗后疗效的准确预测对于为食管鳞状细胞癌量身定制患者治疗至关重要。然而，对于食管癌生存的研究所需的随访时间较长，此次研究无法完整实现，因而选取短期疗效作为新辅助免疫治疗联合化疗后疗效评价指标，在疗效与安全性分析中显示出令人鼓舞的结果。因此，本文综述了短期疗效效果在食管癌新辅助治疗中的研究应用。

Abstract: Esophageal cancer ranks as the sixth leading cause of cancer deaths worldwide, posing a serious threat to human health. In China, the predominant histological type of malignant esophageal tumors is squamous cell carcinoma. Since most patients are diagnosed at an advanced or metastatic stage, traditional treatments—including surgery, chemotherapy, and radiotherapy—yield limited efficacy. Consequently, treatment outcomes remain unsatisfactory, and the five-year survival rate for esophageal malignancies has significant room for improvement, urgently necessitating the exploration of novel therapeutic approaches. Currently, neoadjuvant immunotherapy combined with chemotherapy, represented by PD-1/PD-L1 inhibitors, has demonstrated potential for treating esophageal cancer. Accurate prediction of treatment efficacy following neoadjuvant immunotherapy combined with chemotherapy is crucial for tailoring patient treatment for esophageal squamous cell carcinoma. However, the extended follow-up period required for esophageal cancer survival studies precludes full realization in this investigation. Consequently, short-term efficacy was selected as the outcome measure for evaluating the combination of neoadjuvant immunotherapy and chemotherapy, yielding encouraging results in both efficacy and safety analyses. This review therefore summarizes the application of short-term efficacy outcomes in neoadjuvant treatment for esophageal cancer.