Intestinal Low-Dose Radiotherapy Plus Immunochemotherapy for Conversion of Borderline Resectable/Unresectable Esophageal Squamous Cell Carcinoma

Inclusion Criteria

• •1. Patients voluntarily enroll in this study, sign an informed consent form, and demonstrate good compliance.
• •2. Age ≥18 years and ≤75 years; both sexes are eligible.
• •3. ECOG performance status score of 0-1.
• •4. Pathologically confirmed esophageal squamous cell carcinoma (ESCC) prior to surgery.
• •5. Thoracic esophageal cancer.
• •6. Unresectable lesions, defined as: T4 stage; marginally resectable T3 stage (invading other organs, e.g., trachea, bronchus, or aorta not ruled out by imaging); presence or absence of unresectable lymph nodes or metastatic lymph nodes invading adjacent organs; presence or absence of supraclavicular lymph node metastasis; or clinically confirmed unresectable disease by the surgeon.
• •7. No prior history of anti-tumor treatment, including chemotherapy, hormonal therapy, radiotherapy, or immunotherapy.
• •8. Baseline laboratory requirements (within 7 days prior to enrollment):
• •Hematology:
• •1. Hb≥90 g/L (no transfusion within 14 days)
• •2. NEUT ≥1.5×10⁹/L
• •3. PLT ≥100×10⁹/L
• •4. WBC≥3×10⁹/L
• •Biochemistry:
• •1. ALT and AST≤2.5×ULN
• •2. TBIL≤1.5×ULN
• •9. Female subjects need to agree to use contraception during the study and for 6 months post-study; serum pregnancy test negative within 7 days prior to enrollment; non-lactating. Male subjects must agree to use contraception during the study and for 6 months post-study.
• •10. No psychological, familial, social, or geographical factors that may impair protocol adherence.
• •11. Other parameters meet general clinical trial enrollment criteria.
• •12. The subject or authorized representative has read, fully understands the patient information sheet, and signed the informed consent form.