The Adjuvant Treatment of Esophageal Cancer.
Adjuvant radiation therapy for esophageal cancer can be delivered preoperatively andøor postoperatively. Although one series reports a significant decrease in localøregional failure and two report a survival advantage, when the data are combined, there is no clear advantage for preoperative radiation therapy. One of the two trials of postoperative radiation therapy used conventional radiation doses and did report a significant decrease in localøregional failure. However, this improvement was seen only in node-negative patients. Overall, there is limited benefit to adjuvant radiation therapy in the treatment of esophageal cancer. The more innovative approach of radiation therapy plus chemotherapy, either in the adjuvant setting or as a primary treatment modality, holds greater promise.
Minsky
BD
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA