Current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinoma
Esophageal squamous cell carcinoma (ESCC) is an aggressive and fatal disease that is usually diagnosed when the chances for surgical intervention has been missed. Definitive concurrent chemoradiotherapy (dCRT) is the first choice of treatment for inoperable locally advanced esophageal squamous cell...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1303068/full |
| _version_ | 1827373747707838464 |
|---|---|
| author | Renxian Xie Renxian Xie Qingxin Cai Tong Chen Tong Chen Hongxin Huang Hongxin Huang Chuangzhen Chen |
| author_facet | Renxian Xie Renxian Xie Qingxin Cai Tong Chen Tong Chen Hongxin Huang Hongxin Huang Chuangzhen Chen |
| author_sort | Renxian Xie |
| collection | DOAJ |
| description | Esophageal squamous cell carcinoma (ESCC) is an aggressive and fatal disease that is usually diagnosed when the chances for surgical intervention has been missed. Definitive concurrent chemoradiotherapy (dCRT) is the first choice of treatment for inoperable locally advanced esophageal squamous cell carcinoma (LA-ESCC). Nevertheless, the local recurrence rate for esophageal cancer patients undergoing dCRT remains high at 40-60%, with a 5-year overall survival rate of solely 10-30%. Immunotherapy in combination with dCRT is a promising treatment for inoperable LA-ESCC, for that improved long-term survival is expected. The present review provides a comprehensive overview of the evolutionary trajectory of dCRT for LA-ESCC, delineates notable relevant clinical studies, addresses unresolved concerns regarding the combination of dCRT with immunotherapy, and highlights promising directions for future research. When dCRT is combined with immunotherapy, the following aspects should be carefully explored in the future studies, including the optimal irradiation dose, segmentation scheme, radiotherapy technique, timing, sequence and duration of radiotherapy, and the selection of chemotherapeutic and immunologic drugs. In addition, further investigations on the mechanisms of how dCRT combined with immunotherapy exerts synergistic anti-tumor effects and molecular biomarkers ensuring precise screening of ESCC patients are needed. |
| first_indexed | 2024-03-08T11:20:52Z |
| format | Article |
| id | doaj.art-cf550e6ab6644cb894a195f47df80a8e |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-08T11:20:52Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-cf550e6ab6644cb894a195f47df80a8e2024-01-26T09:46:49ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-01-011410.3389/fonc.2024.13030681303068Current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinomaRenxian Xie0Renxian Xie1Qingxin Cai2Tong Chen3Tong Chen4Hongxin Huang5Hongxin Huang6Chuangzhen Chen7Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, ChinaShantou University Medical College, Shantou, ChinaDepartment of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, ChinaDepartment of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, ChinaShantou University Medical College, Shantou, ChinaDepartment of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, ChinaShantou University Medical College, Shantou, ChinaDepartment of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, ChinaEsophageal squamous cell carcinoma (ESCC) is an aggressive and fatal disease that is usually diagnosed when the chances for surgical intervention has been missed. Definitive concurrent chemoradiotherapy (dCRT) is the first choice of treatment for inoperable locally advanced esophageal squamous cell carcinoma (LA-ESCC). Nevertheless, the local recurrence rate for esophageal cancer patients undergoing dCRT remains high at 40-60%, with a 5-year overall survival rate of solely 10-30%. Immunotherapy in combination with dCRT is a promising treatment for inoperable LA-ESCC, for that improved long-term survival is expected. The present review provides a comprehensive overview of the evolutionary trajectory of dCRT for LA-ESCC, delineates notable relevant clinical studies, addresses unresolved concerns regarding the combination of dCRT with immunotherapy, and highlights promising directions for future research. When dCRT is combined with immunotherapy, the following aspects should be carefully explored in the future studies, including the optimal irradiation dose, segmentation scheme, radiotherapy technique, timing, sequence and duration of radiotherapy, and the selection of chemotherapeutic and immunologic drugs. In addition, further investigations on the mechanisms of how dCRT combined with immunotherapy exerts synergistic anti-tumor effects and molecular biomarkers ensuring precise screening of ESCC patients are needed.https://www.frontiersin.org/articles/10.3389/fonc.2024.1303068/fullesophageal squamous cell carcinomaconcurrent chemoradiotherapyradiotherapychemotherapyimmunotherapy |
| spellingShingle | Renxian Xie Renxian Xie Qingxin Cai Tong Chen Tong Chen Hongxin Huang Hongxin Huang Chuangzhen Chen Current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinoma Frontiers in Oncology esophageal squamous cell carcinoma concurrent chemoradiotherapy radiotherapy chemotherapy immunotherapy |
| title | Current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinoma |
| title_full | Current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinoma |
| title_fullStr | Current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinoma |
| title_full_unstemmed | Current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinoma |
| title_short | Current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinoma |
| title_sort | current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinoma |
| topic | esophageal squamous cell carcinoma concurrent chemoradiotherapy radiotherapy chemotherapy immunotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1303068/full |
| work_keys_str_mv | AT renxianxie currentandfutureondefinitiveconcurrentchemoradiotherapyforinoperablelocallyadvancedesophagealsquamouscellcarcinoma AT renxianxie currentandfutureondefinitiveconcurrentchemoradiotherapyforinoperablelocallyadvancedesophagealsquamouscellcarcinoma AT qingxincai currentandfutureondefinitiveconcurrentchemoradiotherapyforinoperablelocallyadvancedesophagealsquamouscellcarcinoma AT tongchen currentandfutureondefinitiveconcurrentchemoradiotherapyforinoperablelocallyadvancedesophagealsquamouscellcarcinoma AT tongchen currentandfutureondefinitiveconcurrentchemoradiotherapyforinoperablelocallyadvancedesophagealsquamouscellcarcinoma AT hongxinhuang currentandfutureondefinitiveconcurrentchemoradiotherapyforinoperablelocallyadvancedesophagealsquamouscellcarcinoma AT hongxinhuang currentandfutureondefinitiveconcurrentchemoradiotherapyforinoperablelocallyadvancedesophagealsquamouscellcarcinoma AT chuangzhenchen currentandfutureondefinitiveconcurrentchemoradiotherapyforinoperablelocallyadvancedesophagealsquamouscellcarcinoma |