Review of radiotherapy combined with systemic therapy for advanced esophageal cancer: from chemotherapy to immunotherapy era

Advanced esophageal cancer is characterized by poor prognosis and high recurrence rates, even after receiving standard radical treatments. Current treatment guidelines primarily recommend systemic therapy combined with palliative and supportive care for advanced esophageal cancer, particularly in pa...

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Main Authors: Ji Jianrui, Liu Yunsong, Bao Yongxing, Men Yu, Wang Jun, Hui Zhouguang
Format: Article
Language:English
Published: EDP Sciences 2025-01-01
Series:Visualized Cancer Medicine
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Online Access:https://vcm.edpsciences.org/articles/vcm/full_html/2025/01/vcm20240017/vcm20240017.html
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author Ji Jianrui
Liu Yunsong
Bao Yongxing
Men Yu
Wang Jun
Hui Zhouguang
author_facet Ji Jianrui
Liu Yunsong
Bao Yongxing
Men Yu
Wang Jun
Hui Zhouguang
author_sort Ji Jianrui
collection DOAJ
description Advanced esophageal cancer is characterized by poor prognosis and high recurrence rates, even after receiving standard radical treatments. Current treatment guidelines primarily recommend systemic therapy combined with palliative and supportive care for advanced esophageal cancer, particularly in patients with limited functional status. Despite the recent advances, including the introduction of immunotherapy, overall survival of these patients remains limited. Radiotherapy, traditionally used for palliative purposes, is increasingly being explored as an adjunct to systemic therapies, including chemotherapy and immunotherapy, to improve clinical outcomes. This review aims to examine the current literature on the role of radiotherapy combined with systemic therapies for advanced esophageal cancer. The impact of these combined approaches on overall survival (OS), progression-free survival (PFS), and quality of life was analyzed, focusing on patient selection criteria, optimal treatment strategies, and the timing of radiotherapy administration. Studies have shown that radiotherapy combined with systemic therapy may offer survival benefits, particularly in patients with oligometastasis or limited metastatic disease. Furthermore, the synergistic effects of radiotherapy combined with immunotherapy are promising. However, the impact of such a combination need to be further investigated. Nonetheless, various challenges, including lack of consensus on optimal radiotherapy protocols, appropriate sequencing with systemic treatments, and identification of patient populations most likely to benefit, limit the application of this combination therapy. Therefore, large-scale prospective clinical trials are needed to validate these approaches and refine treatment guidelines for improved prognosis and management of patients with advanced esophageal cancer.
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spelling doaj-art-7160a11fbaaf4bcda662b202c686e72d2025-08-20T03:05:45ZengEDP SciencesVisualized Cancer Medicine2740-42182025-01-016510.1051/vcm/2025004vcm20240017Review of radiotherapy combined with systemic therapy for advanced esophageal cancer: from chemotherapy to immunotherapy eraJi Jianrui0Liu Yunsong1Bao Yongxing2Men Yu3Wang Jun4Hui Zhouguang5Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAdvanced esophageal cancer is characterized by poor prognosis and high recurrence rates, even after receiving standard radical treatments. Current treatment guidelines primarily recommend systemic therapy combined with palliative and supportive care for advanced esophageal cancer, particularly in patients with limited functional status. Despite the recent advances, including the introduction of immunotherapy, overall survival of these patients remains limited. Radiotherapy, traditionally used for palliative purposes, is increasingly being explored as an adjunct to systemic therapies, including chemotherapy and immunotherapy, to improve clinical outcomes. This review aims to examine the current literature on the role of radiotherapy combined with systemic therapies for advanced esophageal cancer. The impact of these combined approaches on overall survival (OS), progression-free survival (PFS), and quality of life was analyzed, focusing on patient selection criteria, optimal treatment strategies, and the timing of radiotherapy administration. Studies have shown that radiotherapy combined with systemic therapy may offer survival benefits, particularly in patients with oligometastasis or limited metastatic disease. Furthermore, the synergistic effects of radiotherapy combined with immunotherapy are promising. However, the impact of such a combination need to be further investigated. Nonetheless, various challenges, including lack of consensus on optimal radiotherapy protocols, appropriate sequencing with systemic treatments, and identification of patient populations most likely to benefit, limit the application of this combination therapy. Therefore, large-scale prospective clinical trials are needed to validate these approaches and refine treatment guidelines for improved prognosis and management of patients with advanced esophageal cancer.https://vcm.edpsciences.org/articles/vcm/full_html/2025/01/vcm20240017/vcm20240017.htmladvanced esophageal cancersystemic therapyradiotherapyprognosisreview
spellingShingle Ji Jianrui
Liu Yunsong
Bao Yongxing
Men Yu
Wang Jun
Hui Zhouguang
Review of radiotherapy combined with systemic therapy for advanced esophageal cancer: from chemotherapy to immunotherapy era
Visualized Cancer Medicine
advanced esophageal cancer
systemic therapy
radiotherapy
prognosis
review
title Review of radiotherapy combined with systemic therapy for advanced esophageal cancer: from chemotherapy to immunotherapy era
title_full Review of radiotherapy combined with systemic therapy for advanced esophageal cancer: from chemotherapy to immunotherapy era
title_fullStr Review of radiotherapy combined with systemic therapy for advanced esophageal cancer: from chemotherapy to immunotherapy era
title_full_unstemmed Review of radiotherapy combined with systemic therapy for advanced esophageal cancer: from chemotherapy to immunotherapy era
title_short Review of radiotherapy combined with systemic therapy for advanced esophageal cancer: from chemotherapy to immunotherapy era
title_sort review of radiotherapy combined with systemic therapy for advanced esophageal cancer from chemotherapy to immunotherapy era
topic advanced esophageal cancer
systemic therapy
radiotherapy
prognosis
review
url https://vcm.edpsciences.org/articles/vcm/full_html/2025/01/vcm20240017/vcm20240017.html
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