Esophageal cancer is a common malignant tumor of digestive tract, which seriously threatens the life and health of patients. In recent years, neoadjuvant therapy plays an increasingly important role in the comprehensive treatment of esophageal cancer.
The primary goal
of neoadjuvant therapy is to shrink the tumor. For patients with esophageal cancer, in many cases, the tumor volume is large and may invade the surrounding tissues and organs. The growth and proliferation of tumor cells can be inhibited by neoadjuvant therapy, such as chemotherapy and radiotherapy. Chemotherapeutic drugs can act on tumor cells throughout the body, interfering with their division and metabolic processes. Radiotherapy can precisely target the local tumor tissue of the esophagus, using high-energy radiation to destroy the DNA structure of cancer cells, so that cancer cells lose the ability to reproduce. The reduction of tumor volume can effectively reduce the difficulty of surgical resection. The situation that can not be completely resected or need to resect a large area of tissue may be improved, which helps to improve the radical resection rate of surgery, reduce the possibility of residual tumors, and thus create better conditions for long-term survival of patients.
Secondly, neoadjuvant therapy can reduce the vitality of tumor cells and reduce the risk of dissemination of tumor cells. During the operation, tumor cells may enter the blood circulation or lymphatic system, and then distant metastasis may occur. Neoadjuvant therapy can attack tumor cells before operation and reduce their activity. For example, neoadjuvant chemotherapy can kill some tumor cells in the active division stage, so that cancer cells that might otherwise “escape” during surgery lose their ability to metastasize. Radiotherapy can also block the tiny blood vessels and lymphatic vessels around the tumor, reduce the chance of tumor cells spreading through these pathways, control the metastasis of the tumor to a certain extent, and improve the survival rates of patients.
Moreover, neoadjuvant therapy is useful for assessing the sensitivity of tumors to treatment. The response of esophageal cancer cells to chemotherapy and radiotherapy is different in different patients. In the stage of neoadjuvant therapy, the changes of tumors can be observed. If the tumor responds well to treatment and shrinks significantly, then the treatment regimen is effective for the patient. This not only provides favorable conditions for the follow-up surgical treatment, but also provides a reference for the choice of adjuvant treatment after surgery. For example, if the effect of neoadjuvant chemotherapy is significant, similar chemotherapy drugs may continue to be selected for consolidation therapy after surgery. On the contrary, if the tumor is not sensitive to neoadjuvant therapy, it is necessary to consider adjusting the treatment strategy, such as changing chemotherapy drugs or adding other treatment methods.
In addition, neoadjuvant therapy can improve the survival rate of patients. Through the above effects of tumor shrinkage and reducing the risk of metastasis, the prognosis of patients can be improved. Studies have shown that the long-term survival rate of patients with esophageal cancer who receive neoadjuvant therapy before surgery is improved to a certain extent compared with patients who receive surgery alone. Moreover, neoadjuvant therapy can alleviate the symptoms of patients to a certain extent, such as dysphagia. For some patients with advanced esophageal cancer, dysphagia seriously affects the quality of life. Neoadjuvant therapy may make the tumor partially shrink and the esophageal lumen expand, so as to improve the patient’s eating situation before operation, enhance the patient’s physique, and enable the patient to better tolerate the operation.
In a word, neoadjuvant therapy for patients with esophageal cancer has many important purposes, from improving surgical conditions to controlling tumor metastasis and improving survival rate, which plays a key role in the comprehensive treatment of esophageal cancer and brings more hope for patients.
