Radiation Therapy for Locally Advanced Esophageal Cancer

Stephen G Chun; Heath D Skinner; Bruce D Minsky

doi:10.1016/j.soc.2016.10.006

Radiation Therapy for Locally Advanced Esophageal Cancer

Surg Oncol Clin N Am. 2017 Apr;26(2):257-276. doi: 10.1016/j.soc.2016.10.006. Epub 2017 Feb 10.

Authors

Stephen G Chun¹, Heath D Skinner², Bruce D Minsky²

Affiliations

¹ Division of Radiation Oncology, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. Electronic address: sgchun@mdanderson.org.
² Division of Radiation Oncology, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.

PMID: 28279468
DOI: 10.1016/j.soc.2016.10.006

Abstract

The treatment of locally advanced esophageal cancer is controversial. For patients who are candidates for surgical resection, multiple prospective clinical trials have demonstrated the advantages of neoadjuvant chemoradiation. For patients who are medically inoperable, definitive chemoradiation is an alternative approach with survival rates comparable to trimodality therapy. Although trials of dose escalation are ongoing, the standard radiation dose remains 50.4 Gy. Modern radiotherapy techniques such as image-guided radiation therapy with motion management and intensity-modulated radiation therapy are strongly encouraged with a planning objective to maximize conformity to the intended target volume while reducing dose delivered to uninvolved normal tissues.

Keywords: Chemotherapy; Dose-escalation; Esophageal cancer; IMRT; Radiation.

Publication types

Review

MeSH terms

Chemoradiotherapy / methods*
Dose Fractionation, Radiation
Esophageal Neoplasms / mortality
Esophageal Neoplasms / radiotherapy*
Humans
Neoplasm Staging
Prospective Studies
Radiotherapy Dosage / standards*
Radiotherapy, Intensity-Modulated*
Survival Rate
Treatment Outcome