食管鳞状细胞癌（ESCC）对临床医师构成了巨大挑战，因为其预后不良且治疗选择有限。然而，免疫治疗的最新进展显著改变了ESCC的治疗方案。早期ESCC患者应接受内镜切除手术。如果组织学边缘被肿瘤细胞浸润或存在其他淋巴结转移的危险因素，应进行进一步切除手术。在局部晚期，放化疗仍是标准治疗。在新辅助放化疗和R0切除后无病理完全缓解时，应进行1年免疫治疗以提高无病生存率。在转移性一线治疗中，铂类/荧葩啶类系统化疗与检查点抑制剂的联合是美国所有人的新标准，并且是欧洲程序性死亡配体1阳性患者的新标准。免疫治疗也在二线治疗中获批准。然而，免疫治疗再诱导的益处仍未知，因此，在免疫化疗进展后，标准的二线化疗仍是紫杉醇或伊立替康的首选治疗方案。最重要的是，治疗决策应基于经过知情的患者意愿，并在跨学科肿瘤委员会中进行讨论。本综述总结了我们如何管理ESCC患者，并对欧洲的治疗策略进行了实用概述。版权所有©2023作者底下的Elsevier Ltd。保留所有权利。

Esophageal squamous cell carcinoma (ESCC) poses a major challenge for clinicians as the prognosis is poor and treatment options are limited. However, recent advances in immunotherapy have significantly changed the treatment algorithm of ESCC. Patients with early ESCC should undergo an endoscopic resection. If histological margins are infiltrated with tumor cells or other risk factors for lymph node metastasis are present, further resective surgery should be offered. In a locally advanced setting, radiochemotherapy with or without resection remains the standard of care. In the absence of pathological complete response after neoadjuvant radiochemotherapy and R0 resection, adjuvant immunotherapy for 1 year should be administered to improve disease-free survival. In metastatic first-line setting, combination of platin/fluoropyrimidine-based systemic chemotherapy with checkpoint inhibitors is the novel standard of care for all-comers in the United States and for patients with programmed death-ligand 1 positivity in Europe. Immunotherapy has also been approved in a second-line setting. However, the benefit from immunotherapy reinduction is still unknown and, therefore, standard second-line chemotherapy with taxanes or irinotecan is still the treatment of choice after progression on immunochemotherapy. It is of highest importance that treatment decisions are based on informed patient wishes and are discussed in an interdisciplinary tumor board. This review summarizes how to manage, in our opinion, patients with ESCC and gives a practical overview of the treatment strategies in Europe.Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.