This Article Full Text Full Text (PDF) CME: Take the course for this article: Multiple Management Modalities in Esophageal Cancer: Combined Modality Mana... eLetters: Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Koshy, M. Articles by Matthews, R. H. Search for Related Content PubMed PubMed Citation Articles by Koshy, M. Articles by Matthews, R. H.

Multiple Management Modalities in Esophageal Cancer: Combined Modality Management Approaches

^a Emory University School of Medicine, Department of Radiation Oncology, Atlanta, Georgia, USA; ^b UTHSCSA/San Antonio Cancer Institute, Department of Radiation Oncology, San Antonio, Texas, USA; ^c Beth Israel/Deaconess Medical Center, Harvard Medical School, Department of Radiation Oncology and Boston VA Health Care Radiation Oncology Service, Boston, Massachusetts, USA

Correspondence: Richard H. Matthews, M.D., Ph.D., Department of Radiation Oncology, Beth Israel/Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, Massachusetts 02215, USA. Telephone: 617-232-9500, ext 4457 or ext 5628; Fax: 617-524-0643; e-mail: RHMatthews{at}comcast.net

The overall success rate nationally in treating esophageal carcinomas remains poor, with over 90% of patients succumbing to the disease. In part I of this two-part series, we explored epidemiology, presentation and progression, work-up, and surgical approaches. In part II, we explore the promising suggestions of integrating chemotherapy and radiation therapy into the multimodal management of esophageal cancers.

Alternative approaches to resection alone have been sought because of the overall poor survival rates of esophageal cancer patients, with failures occurring both local-regionally and distantly. Concomitant chemotherapy and radiation therapy (XRT) have been shown, by randomized trial, to be more effective than XRT alone in treating unresectable esophageal cancers and also have shown promise as a neoadjuvant treatment when combined with surgery in the multimodal treatment of this disease. Various studies have also addressed issues such as preoperative chemotherapy, radiation dose escalation, chemotherapy/XRT as a definitive treatment versus use as a surgical adjuvant, and alternative chemotherapy regimens. There are suggestions of some progress, but this remains a difficult problem area in which management is continuing to evolve.

Key Words. Esophageal carcinoma • Multimodal treatment • Survival

This article has been cited by other articles:

				T. J. Kim, K. H. Lee, Y. H. Kim, S. W. Sung, S. Jheon, S.-k. Cho, and K. W. Lee Postoperative Imaging of Esophageal Cancer: What Chest Radiologists Need to Know RadioGraphics, March 1, 2007; 27(2): 409 - 429. [Abstract] [Full Text] [PDF]

				K. L. Prenzel, A. Konig, P. M. Schneider, C. Schnickmann, S. E. Baldus, W. Schroder, E. Bollschweiler, H. P. Dienes, R. P. Mueller, J. R. Izbicki, et al. Reduced Incidence of Nodal Micrometastasis after Major Response to Neoadjuvant Chemoradiation in Locally Advanced Esophageal Cancer Ann. Surg. Oncol., February 1, 2007; 14(2): 954 - 959. [Abstract] [Full Text] [PDF]

				H. S. Vats, T. K. Banerjee, J. Resnick, and Q. Khan Esophageal Adenocarcinoma Arising from Barrett's Dysplasia: A Case Report of Double Occurrence and Prolonged Survival after Chemotherapy. Clin. Med. Res., September 1, 2006; 4(3): 184 - 188. [Abstract] [Full Text] [PDF]

				K. Kumagai, Y. Nimura, A. Mizota, N. Miyahara, M. Aoki, Y. Furusawa, M. Takiguchi, S. Yamamoto, and N. Seki Arpc1b gene is a candidate prediction marker for choroidal malignant melanomas sensitive to radiotherapy. Invest. Ophthalmol. Vis. Sci., June 1, 2006; 47(6): 2300 - 2304. [Abstract] [Full Text] [PDF]