Abstract：
Gastrointestinal cancers are one of the most frequent cancers and a leading cause of cancer deaths worldwide. We provide an overview of the most important practice-changing trials that were either published or presented at the international scientific meetings in 2021-2023. Highlights included reports on three phase III trials (CONCORDE/PRODIGE 26, ARTDECO, and a study by Xu et al.) that evaluated dose escalation in the definitive setting for locally advanced oesophageal cancers, as well as two phase III trials that evaluated the role of chemotherapy (neo-AEGIS) and targeted therapy (NRG/RTOG 1010) in the neoadjuvant setting for adenocarcinoma oesophageal cancers or gastroesophageal junction cancer. CheckMate 577 evaluated nivolumab in patients who had residual pathological disease after neoadjuvant chemoradiation followed by complete resection. The use of radiation therapy for borderline and locally advanced pancreatic cancer is also discussed (SMART and CONKO-007 trials). Stereotactic body radiation therapy followed by sorafenib was compared to sorafenib alone in patients with hepatocellular carcinoma in the NRG/RTOG 1112 study. New options in the management of rectal cancer are emerging such as total neoadjuvant treatment (PRODIGE 23, RAPIDO, PROSPECT), organ preservation (OPRA, OPERA), and the role of immunotherapy in patients with DNA mismatch-repair deficient/microsatellite instability. Finally, preliminary results of the ACT 4 trial that evaluated de-escalation in anal cancer are presented.
摘要：
胃肠道癌症是最常见的癌症之一，也是全球癌症死亡的主要原因。我们概述了在2021-2023年国际科学会议上发表或提出的最重要的实践改变试验。重点包括三个III期试验的报告(CONCORDE/PRODIGE26，ARTDECO，和徐等人的一项研究。)在局部晚期食道癌的确定环境中评估剂量递增，以及两项评估化疗(neo-AEGIS)和靶向治疗(NRG/RTOG1010)在腺癌食管癌或胃食管交界处癌新辅助治疗中的作用的III期试验。CheckMate577评估了新辅助放化疗后完全切除后残留病理疾病的患者的nivolumab。还讨论了放射疗法在临界和局部晚期胰腺癌中的应用（SMART和CONKO-007试验）。在NRG/RTOG1112研究中，在肝细胞癌患者中，将立体定向放射治疗后索拉非尼与单独索拉非尼进行了比较。直肠癌治疗的新选择正在出现，如全新辅助治疗(PRODIGE23，RAPIDO，前景)，器官保存（OPRA，OPERA),以及免疫治疗在DNA错配修复缺陷/微卫星不稳定患者中的作用。最后,提供了评估肛门癌降级的ACT4试验的初步结果。
