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我国是食管癌大国，每年新发和死亡患者均占全球的一半，且我国食管癌病理类型>90%是鳞癌。尽管手术、放疗、化疗和其他治疗方式在不断改进，但在过去的几十年中，食管鳞癌患者的生存率并没有显著提高。目前，对于局部进展期食管鳞癌患者，新辅助放化疗仍是标准治疗，免疫新辅助治疗尚处于探索阶段。在接受免疫新辅助治疗的局部进展期食管鳞癌患者中，部分患者是参与临床探索性研究的，其他患者的使用则是在临床研究范畴之外。因此，由浙江省抗癌协会食管癌专委会发起，浙江大学医学院附属第二医院牵头成立专家组，以多学科协作为基础，涉及胸外科、肿瘤内科和放疗科等多学科，参考国内外最新相关文献，结合中国临床实际，制订了本共识，旨在全周期、多维度、精准指导局部进展期食管鳞癌患者进行免疫新辅助治疗，并且帮助医生规避潜在的风险，更好地作出临床决策。
Abstract：China exhibits a notably high incidence of esophageal cancer, with the annual numbers of new cases and deaths constituting approximately half of the global total. Notably, over 90% of esophageal cancer cases in China are classified as squamous cell carcinoma. Despite advancements in surgical techniques, radiotherapy, chemotherapy, and other therapeutic modalities, the survival rate of patients with esophageal squamous cell carcinoma has not shown a significant improvement over the past few decades. Currently, neoadjuvant chemoradiotherapy remains the standard treatment for patients with locally advanced esophageal squamous cell carcinoma, while immunoneoadjuvant therapy is still under investigation. Among patients with locally advanced esophageal squamous cell carcinoma who receive immunoneoadjuvant therapy, some are enrolled in exploratory clinical studies, whereas others receive treatments that fall outside the scope of clinical research. Consequently, the Esophageal Cancer Specialized Committee of the Zhejiang Anti-Cancer Association initiated the formation of an expert working group under the leadership of the Second Affiliated Hospital of Zhejiang University School of Medicine. This consensus was developed through a multidisciplinary collaboration that encompassed fields such as thoracic surgery, medical oncology, and radiotherapy. It integrates the latest relevant literature from both domestic and international sources with the clinical realities in China. The objective is to offer comprehensive, multi-dimensional, and precise guidance for immunoneoadjuvant therapy in patients with locally advanced esophageal squamous cell carcinoma, thereby assisting physicians in mitigating potential risks and enhancing clinical decision-making.
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基本信息:
DOI：10.13267/j.cnki.syzlzz.2025.073
中图分类号:
引用信息:
[1]浙江省抗癌协会食管癌专委会.食管鳞癌免疫治疗用于新辅助治疗浙江省专家共识（2025版）[J],2025,40(06):499-510.DOI:10.13267/j.cnki.syzlzz.2025.073.
基金信息:
浙江省重点研发项目(领雁计划攻关项目)(2023C03064);科技部国家重点研发项目(2023YFF1204404)