Changing role of radiotherapy in the management of cancer of the esophagus.
BACKGROUND
Cancer of the esophagus remains a highly lethal disease, but new treatment approaches that build onto traditional surgical and radiotherapeutic methods are making an impact on organ preservation while offering hope for improved survival.


METHODS
Reviewed here are recent data from trials on the use of new radiotherapeutic approaches.


RESULTS
There is clinical trial evidence for improved treatment results with radiotherapy and concurrent systemic chemotherapy. For some patients with responsive cancers, the use of chemoradiation results in about 25% being cured-a marked departure from the results of treatment with radiotherapy alone in the preceding decades. This idea is being explored further with new trials using advanced radiotherapy treatment planning systems called "conformal therapy," in which the high irradiation dose envelope is designed to fit tightly around the cancer.


CONCLUSIONS
Cancer of the esophagus can now be treated aggressively with chemoradiation to offer a choice for local symptom control, organ preservation, and cure.
Rich
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Department of Radiation Oncology, University of Virginia Health System, Charlottesville 22908-0001, USA.
D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D010166:Palliative Care; D011379:Prognosis; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal; D016019:Survival Analysis; D016896:Treatment Outcome