[Emerging Radiotherapy for Esophageal Cancer]

Radiotherapy plays a central role in the management of esophageal cancer, encompassing definitive, neoadjuvant, and palliative indications.Recent advances in linear accelerator-based technologies, such as intensity-modulated radiotherapy(IMRT)and volumetric-modulated arc therapy(VMAT), have enabled improved target coverage and significant reductions in cardiac and pulmonary doses, resulting in better treatment outcomes.Dynamic trajectory radiotherapy(DTRT), which synchronously controls gantry and couch motion, represents an innovative approach that allows three-dimensional beam trajectory optimization and further sparing of critical organs.Particle beam therapy using protons or carbon ions achieves highly conformal dose distributions with reduced cardiopulmonary toxicity and may enhance therapeutic efficacy when combined with systemic therapy or through the preservation of host immunity.Artificial intelligence(AI)is transforming radiotherapy workflows by enabling automatic contouring, adaptive replanning, and predictive modeling through radiomics.These technologies contribute to the standardization and individualization of treatment by improving prognostic and toxicity predictions.Concurrently, combined modality strategies integrating radiotherapy with immune checkpoint inhibitors and oncolytic viral therapies are under active clinical investigation.Early-phase trials have demonstrated favorable safety profiles and promising local control rates.Ongoing prospective multi-institutional trials and large-scale data analyses are essential to validate the clinical benefits and long-term safety of these novel modalities.The integration of technological innovations and biological insights is expected to drive further improvements in local control, toxicity reduction, and survival outcomes, establishing radiotherapy as an increasingly precise and biologically guided treatment modality for esophageal cancer.