Radiation Therapy in Esophageal/Gastroesophageal Cancer

Living reference work entry

Abstract

Esophageal cancer is a highly aggressive disease, characterized by a rapid lymphatic and hematological spread, resulting in a 5-year overall survival from 15% to 25%. Although the incidence of squamous cell carcinoma has declined, the incidence of adenocarcinoma has risen in the western world due to increase in obesity and gastroesophageal reflux disease. The predominant symptom is dysphagia and the majority of the patients have an advanced stage at diagnosis. Radical resection has long been the mainstay of treatment in patients with loco-regionally advanced disease. However, the outcome with this single modality treatment was poor. In order to improve outcome, several neoadjuvant and adjuvant strategies using chemotherapy or chemoradiotherapy have been investigated, and a multimodal approach is now standard of care.

Radiation therapy has an important role in the management of esophageal cancer, both in the preoperative and in the nonsurgical and palliative setting. However, there is still no gold standard regarding the extent of the irradiated volume and the appropriate fractionation schedule to use. Efforts to minimize treatment-related toxicity while improving outcome in this disease should be continued preferentially in the framework of well-conducted studies.

Keywords

Esophageal cancer Gastroesophageal junction cancer Radiation therapy Multimodal treatment 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of OncologyKU Leuven – University of LeuvenLeuvenBelgium
  2. 2.Department of Radiation OncologyUniversity Hospitals LeuvenLeuvenBelgium

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