[Current Status and Future Prospects of Chemoradiotherapy for Esophageal Cancer].
Chemoradiotherapy is a very important factor and one of the 2 pillars of esophageal cancer treatment. Although esophagectomy is the standard treatment for clinical stage Ⅰ(T1N0M0)esophageal cancer, chemoradiotherapy is reported to be effective. Currently, a phaseⅢ clinical trial is underway to compare patients who undergo esophagectomy and those who receive radical chemoradiotherapy. Esophagectomy after neoadjuvant chemotherapy is the standard treatment for clinical stageⅡ/Ⅲ(except for T4) esophageal cancer, whereas chemoradiotherapy is regarded as the standard treatment for patients who wish to preserve their esophagus, those who refuse surgery, and those with inoperable disease. Chemoradiotherapy, rather than surgical treatment, is usually selected for clinical stageⅣ (T4/M1LYM) esophageal cancer. While curability increases with chemoradiotherapy, late adverse events such as cardiopulmonary toxicity and safety problems with salvage treatment of cases with residual tumor or recurrent cancer have been observed. New irradiation techniques using radiation technology are being developed, such as intensity-modulated radiation therapy (IMRT). These innovations are expected to improve treatment results by avoiding irradiation of at-risk organs, without reducing the target radiation volume. New treatments, including salvage protocols, introduction of new radiotherapy equipment such as IMRT, and new drugs, are being developed, and further advances are anticipated.
Division of Gastrointestinal Surgery, Kobe University Hospital.
Tomoaki
T
Aoki
Tetsu
T
Nakamura
Yoshihiro
Y
Kakeji
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D012008:Recurrence