Radiotherapy of carcinoma of the esophagus in China--a review.
The incidence and mortality of carcinoma of the esophagus vary in different parts of the world, and are very high in northern China (109/100,000). Anatomic and pathological considerations of esophageal carcinoma show that in most cases it is difficult to cure by surgery alone, and radiotherapy thus becomes important. Unfortunately, results of radiotherapy have been mostly poor, with the 5-year survival rates reported in the literature being about 10% for radiation treatment alone and 25% in selected cases using multidisciplinary treatment. The results at the Cancer Hospital of the Shanghai Medical University are 16.8% and 25.2%, respectively, in 1034 cases. Based on personal experience as well as current Chinese and Western literature, the author will discuss the diagnosis and staging of carcinoma of the esophagus and the increasing importance of CT scans. The relationship of various factors to the outcome of radiotherapy is discussed; length of disease and site of lesion are both important. Optimal dosage is 65 Gy, giving a 5-year survival rate of 18.5% as compared to doses less than 60 Gy and above 70 Gy (10% 5-year survival). The possibilities of future investigations in the radiation treatment of esophageal carcinoma are reviewed. Collaboration between countries having large numbers of esophageal carcinoma patients with those having modern scientific resources would help to solve many questions in a shorter time.
Taifu
L
L
Dept. of Radiation Oncology, Cancer Hospital, Shanghai Medical University, P.R. China.
D002681:China; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans