Esophageal cancer, ranked as the eighth most prevalent cancer globally, is characterized by a low survival rate and poor prognosis. Concurrent chemoradiation therapy (CCRT) is the standard therapy in the non-surgical treatment of localized carcinoma of the esophagus. Nevertheless, the radiation doses employed in CCRT remain notably lower compared to the curative definite chemoradiation therapy utilized in the management of other carcinomas. In order to increase the local control rates and enhance the treatment outcomes, several clinical trials have used high-dose radiation to analyze the effect of dose escalation. Despite the integration of technically advanced RT schemes such as intensity-modulated radiation therapy (IMRT), the results of these trials have failed to demonstrate a significant improvement in overall survival or local progression-free survival. In this review, we investigated previous clinical trials to determine the ineffectiveness of radiation dose escalation in the context of CCRT for esophageal cancer. We aim to clarify the factors contributing to the limited efficacy of escalated radiation doses in improving patient outcomes. Furthermore, we delve into recent research endeavors, exploring prospective radiation dose modifications being altered based on the histological characteristics of the carcinoma. The exploration of these recent studies not only sheds light on potential refinements to the existing treatment protocols but also seeks to identify novel approaches that may pave the way for more efficacious and personalized therapeutic strategies for esophageal cancer management.
食管癌作为全球第八大常见癌症，其特点是生存率低且预后不良。对于局部食管癌的非手术治疗，同步放化疗（CCRT）是标准疗法。然而，与其他癌症治疗中使用的根治性放化疗相比，CCRT中采用的放射剂量仍然显著较低。为了提高局部控制率并改善治疗效果，多项临床试验已采用高剂量放疗来评估剂量递增的效果。尽管引入了调强放射治疗（IMRT）等技术先进的放疗方案，这些试验的结果并未显示总生存期或局部无进展生存期有显著改善。本文回顾了既往临床试验，以探讨食管癌CCRT中放射剂量递增效果不佳的原因。我们旨在阐明限制剂量递增在改善患者预后方面效果的因素。此外，我们还深入探讨了近期研究，探索基于癌组织学特征调整放射剂量的前瞻性方案。这些最新研究不仅为现有治疗方案的优化提供了启示，还致力于探索可能为食管癌治疗带来更有效、更个性化策略的新途径。
肿瘤(癌症)患者之家