【摘要】 食管癌是全球高发的消化道恶性肿瘤，放疗作为其综合治疗的核心手段之一，在局部晚期患者根治、术后辅助治疗及姑息治疗中发挥关键作用。但临床中食管癌患者放疗敏感性存在显著个体差异，部分患者因放疗抵抗导致治疗失败、肿瘤复发及转移，严重影响预后。生物标志物作为反映肿瘤细胞生物学行为、预测治疗反应的关键指标，为食管癌放疗个体化方案制定、疗效评估及预后判断提供了重要参考。文章按功能性将生物标志物分为接触(暴露)标志物、效应标志物、敏感性标志物3类进行综述，并重点阐述这些标志物在食管癌诊断初期、治疗过程中及治疗结束后3个阶段的变化特点及临床应用价值。系统梳理其作用机制与临床研究进展，探讨当前挑战与未来方向，为食管癌放疗个体化策略提供理论依据。更多还原

【Abstract】 Esophageal cancer is a highly prevalent malignant tumor of the digestive tract worldwide. Radiotherapy, as one of the core methods of comprehensive treatment, plays a key role in the radical treatment, postoperative adjuvant therapy,and palliative care of locally advanced patients. However, there are significant individual differences in radiotherapy sensitivity among esophageal cancer patients in clinical practice. Some patients may experience treatment failure, tumor recurrence, and metastasis due to radiotherapy resistance, which seriously affects prognosis. Biomarkers, as key indicators reflecting the biological behavior of tumor cells and predicting treatment response, provide important references for the development of individualized radiotherapy plans, efficacy evaluation, and prognosis judgment for esophageal cancer. This article categorizes biomarkers by function into three types: exposure(contact) biomarkers, effect biomarkers, and sensitivity biomarkers. It provides a comprehensive review of these biomarkers, focusing on their characteristics and clinical application value during the initial diagnosis, treatment process, and post-treatment stages of esophageal cancer. It systematically summarizes their mechanism of action and clinical research progress, explores current challenges and future directions, and provides a theoretical basis for individualized radiotherapy strategies for esophageal cancer.更多还原