Expert consensus on radiotherapy combined with immunotherapy for esophageal cancer (2024 edition)

Radiotherapy represents an essential treatment approach for esophageal cancer. Over recent years, immunotherapy combined with chemotherapy has become the first-line standard treatment for patients with advanced esophageal cancer. Several phase III studies on immunotherapy combined with radiotherapy for locally advanced esophageal cancer are currently underway. Sufficient evidence-based medical data are urgently needed to support the integration of immunotherapy and chemoradiotherapy as a new treatment strategy for patients with locally advanced esophageal cancer. This consensus, formulated based on the latest study results, in-depth research, and thorough discussions, provides a comprehensive set of recommendations. The document extensively covers treatment strategies and evaluation methods for radiotherapy combined with immunotherapy across patients with operable esophageal cancer, inoperable locally advanced esophageal cancer, and advanced esophageal cancer. Moreover, common complications and radiation-related issues associated with radiotherapy combined with immunotherapy are discussed, serving as clinical guidance. Our expert group comprised members from the Professional Committee of Radiation Oncology, China Anti-Cancer Association, the Branch of Radiation Oncology, Chinese Medical Association, and the Branch of Radiation Oncology Treatment Physician, Chinese Medical Doctor Association.