Successive radiation and surgical treatment of esophageal cancer

On the basis of our extensive experience with radiation therapy, surgery, and combined therapy in the treatment of esophageal cancer, we substantiate a basis for giving irradiation followed by surgery. With the high efficacy of radiotherapy (RT), achieving tumor regression of more than 75% with a dose 40-50 Gy, it is expedient to continue RT using a radical programme. This may lead to full recovery without any surgical intervention. However, these patients must be followed-up. If tumor growth continues or if there appears a recurrence of tumor later, a radical operation must be performed (56 clinical cases). During the operation, extirpation of the esophagus with esophagoplasty, or its resection with a one-staged reconstruction with the gastrointestinal tract, is possible. The latter is preferred, as it not only increases the patients' life-span with comparatively low operative mortality, but results in full recovery of some patients.