食管癌寡转移放射治疗专家共识(2025年版)  

Experts consensus on radiotherapy for patients with oligometastatic esophageal cancer(2025 edition)

作　　者：中国医师协会放射肿瘤治疗医师分会 中华医学会放射肿瘤治疗学分会 中国抗癌协会肿瘤放射治疗专业委员会 中国肿瘤放射治疗联盟食管癌专家委员会 王军[2] 惠周光[3] 庞青松[4] 周志国 吕晓岩 Radiation Oncology Treatment Physician Branch,Chinese Medical Doctor Association;Branch of Radiation Oncology Therapy,Chinese Medical Association;Professional Committee of Radiotherapy for Cancer,Chinese Anti-cancer Association;Expert Committee of Esophageal Cancer,Chinese Cancer Radiotherapy Alliance;Wang Jun;Hui Zhouguang;Pang Qingsong(不详;Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Tianjin Medical University Cancer Institute&Hospital,Tianjin 300060,China)

机构地区：[1]不详 [2]河北医科大学第四医院,石家庄050011 [3]中国医学科学院肿瘤医院,北京100021 [4]天津医科大学肿瘤医院,天津300060 [5]河北医科大学第四医院

出　　处：《中华放射医学与防护杂志》2025年第1期1-17,共17页Chinese Journal of Radiological Medicine and Protection

基　　金：中央引导地方科技发展资金项目(科技创新基地项目)(246Z7707G)。

摘　　要：食管癌患者约40%在初次诊断时就已出现转移。尽管免疫治疗改变了晚期、复发或转移性食管癌的治疗格局,但系统性治疗的手段仍然有限,预后欠佳。寡转移被认为是介于局部转移和广泛转移的中间阶段。有研究显示,在系统性治疗的基础上联合放疗等局部治疗可能改善多种实体瘤中寡转移患者的生存,包括食管癌寡转移。目前关于食管癌寡转移放射治疗的介入时机、剂量、技术等问题,仍缺乏大型随机临床试验的数据支持。综合近年来食管癌寡转移研究的数据,中国医师协会放射肿瘤治疗医师分会、中华医学会放射肿瘤治疗学分会、中国抗癌协会肿瘤放射治疗专业委员会、中国肿瘤放射治疗联盟食管癌专家委员会组织专家组成员,经过深入讨论、多次修改,共同制定了该共识。针对食管癌寡转移进行了较为明确的定义及分类,并基于当前的医学证据对放疗常见问题进行梳理总结,以期为食管癌寡转移放射治疗临床实践提供参考及学术性指导意见。Approximately 40%of esophageal cancer patients have metastatic disease at the time of initial diagnosis.Although immunotherapy has changed the treatment pattern of advanced,recurrent or metastatic esophageal cancer,the options for systemic treatment for these patients are still limited,and the prognosis is poor.Oligometastasis is an intermediate stage between locoregional and widespread systemic metastasis.Some studies have shown that combining systemic treatment with local treatment,such as radiotherapy,may improve the survival of patients with oligometastasis in various solid tumors,including esophageal cancer.At present,there is still a lack of data support from large randomized clinical trials on the timing,dose,and technique of radiotherapy for oligometastatic esophageal cancer.Based on recent studies on oligometastatic esophageal cancer,this consensus was jointly developed after in⁃depth discussions and multiple revisions by experts from the following organizations:Radiation Oncology Treatment Physician Branch,Chinese Medical Doctor Association;Branch of Radiation Oncology Therapy,Chinese Medical Association;Professional Committee of Radiotherapy for Cancer,Chinese Anti⁃cancer Association;Expert Committee of Esophageal Cancer,Chinese Radiation Therapy Oncology Group.This consensus provides a relatively clear definition and classification of oligometastatic esophageal cancer.It summarizes common problems in radiotherapy based on current medical evidence,to provide reference and academic guidance for the clinical practice of radiotherapy for oligometastatic esophageal cancer.

关 键 词：食管癌 寡转移 放射治疗 专家共识 

分 类 号：R735.1[医药卫生—肿瘤]