title: The rationale and evidence for radiotherapy in the management of gastroesophageal junction tumors.
abstract: Adenocarcinoma of the gastroesophageal junction (GE-junction) is a frequent disease with a rising incidence. The optimal treatment of localized disease is the subject of many randomized trials and meta-analyses studying the role of preoperative chemotherapy or preoperative chemoradiation compared with surgery alone. A complicating factor in interpreting the results of these trials is the fact that GE-junction tumors are sometimes regarded as esophageal tumors, although in other studies they are regarded as gastric cancers. A thorough review of the literature including meta-analyses clearly indicates that there is a role for preoperative chemoradiation in locally advanced GE-junction tumors. Based on the available evidence a surgery alone arm in future randomized trials for locally advanced GE junction tumors can no longer be regarded as a standard arm.
authors.affiliation: From the Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, and Department of Oncology, KU Leuven, Leuven, Belgium.
authors.forename: Karin
authors.initials: K
authors.lastname: Haustermans
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects; D013505:Digestive System Surgical Procedures; D019583:Dose Fractionation, Radiation; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D004943:Esophagogastric Junction / Q000473:pathology / Q000528:radiation effects*; D019317:Evidence-Based Medicine; D006801:Humans; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome