在免疫疗法时代优化局部晚期食管癌的放射靶体积。

IF 3.6 3区 医学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Expert Opinion on Biological Therapy Pub Date : 2024-10-26 DOI:10.1080/14712598.2024.2423009
Jian Zheng, Zhunhao Zheng, Tian Zhang, Xi Chen, Qingsong Pang, Ping Wang, Cihui Yan, Wencheng Zhang
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引用次数: 0

摘要

简介局部晚期食管癌(EC)预后较差。初步临床研究表明,放疗联合免疫疗法对食管癌具有协同疗效。调整放疗靶体积以保护免疫功能有利于免疫疗法。然而,对于EC靶体积的确切定义,目前还没有明确的共识:临床前研究为免疫疗法与不同放疗模式的结合提供了大量信息,多项临床研究评估了免疫疗法与放疗结合对局部晚期EC的影响。在此,我们从患者预后、放疗失败模式、治疗相关毒性、肿瘤淋巴结消耗、全身免疫等方面阐述了放疗靶区的合理划分,并总结了放疗联合免疫治疗在EC中的临床试验:我们建议在局部晚期EC的免疫治疗与化学放疗(CRT)联合应用时,对照射野采用介入野照射(IFI)而非选择性结节照射(ENI)。我们期待在临床试验中对这一靶点设计进行评估,以进一步探索更精确的诊断模式、长期毒性反应和生存质量,以及个性化治疗的分层因素,为患者带来更多治疗获益。
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Optimization of radiation target volume for locally advanced esophageal cancer in the immunotherapy era.

Introduction: Locally advanced esophageal cancer (EC) has poor prognosis. Preliminary clinical studies have demonstrated the synergistic efficacy of radiotherapy combined with immunotherapy in EC. Adjusting the radiotherapy target volume to protect immune function favors immunotherapy. However, there is no clear consensus on the exact definition of the EC target volume.

Areas covered: Preclinical studies have provided a wealth of information on immunotherapy combined with different radiotherapy modalities, and several clinical studies have evaluated the impact of immunotherapy combined with radiotherapy on locally advanced EC. Here, we illustrate the rational target volume delineation for radiotherapy in terms of patient prognosis, pattern of radiotherapy failure, treatment-related toxicities, tumor-draining lymph nodes, and systemic immunity and summarize the clinical trials of radiotherapy combined with immunotherapy in EC.

Expert opinion: We recommend applying involved-field irradiation (IFI) instead of elective nodal irradiation (ENI) for irradiated fields when immunotherapy is combined with chemoradiotherapy (CRT) for locally advanced EC. We expect that this target design will be evaluated in clinical trials to further explore more precise diagnostic modalities, long-term toxic responses, and quality of survival, and stratification factors for personalized treatment, and to provide more treatment benefits for patients.

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来源期刊
Expert Opinion on Biological Therapy
Expert Opinion on Biological Therapy 医学-生物工程与应用微生物
CiteScore
8.60
自引率
0.00%
发文量
96
审稿时长
3-8 weeks
期刊介绍: Expert Opinion on Biological Therapy (1471-2598; 1744-7682) is a MEDLINE-indexed, international journal publishing peer-reviewed research across all aspects of biological therapy. Each article is structured to incorporate the author’s own expert opinion on the impact of the topic on research and clinical practice and the scope for future development. The audience consists of scientists and managers in the healthcare and biopharmaceutical industries and others closely involved in the development and application of biological therapies for the treatment of human disease. The journal welcomes: Reviews covering therapeutic antibodies and vaccines, peptides and proteins, gene therapies and gene transfer technologies, cell-based therapies and regenerative medicine Drug evaluations reviewing the clinical data on a particular biological agent Original research papers reporting the results of clinical investigations on biological agents and biotherapeutic-based studies with a strong link to clinical practice Comprehensive coverage in each review is complemented by the unique Expert Collection format and includes the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results; Article Highlights – an executive summary of the author’s most critical points.
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