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Primary combined-modality therapy for esophageal cancer
1Weill Medical College of Cornell University, Department of Radiation Oncology, Memorial Sloan-Kettering, Cancer Center, New York, New York, 10021, USA.
Oncology (Williston Park, N.Y.)
|June 3, 2006
Summary
Combined-modality therapy is standard for esophageal carcinoma. However, intensifying this treatment did not improve outcomes, and further research is exploring new systemic agents and radiation techniques.
Area of Science:
- Oncology
- Radiation Therapy
- Medical Imaging
Background:
- The Radiation Therapy Oncology Group (RTOG) 85-01 trial established combined-modality therapy as the standard nonsurgical treatment for esophageal carcinoma.
- Subsequent trials, such as Intergroup (INT)-0123/RTOG 94-05, investigated dose intensification of this regimen without significant improvement in outcomes.
Purpose of the Study:
- To evaluate the efficacy of dose-intensified combined-modality therapy for esophageal carcinoma.
- To identify future research directions in esophageal cancer treatment.
Main Methods:
- Analysis of data from the Intergroup (INT)-0123/RTOG 94-05 trial, which examined dose intensification of the RTOG 85-01 regimen.
- Review of current clinical investigations in esophageal cancer therapy.
Main Results:
- Dose intensification of the established combined-modality therapy regimen did not lead to improved local control or survival rates.
- The role of surgery after primary combined-modality therapy in improving survival remains controversial.
Conclusions:
- Current combined-modality therapy regimens require further optimization.
- Future research should focus on novel systemic agents, advanced radiation planning using 18F-fluorodeoxyglucose positron-emission tomography, and identifying prognostic molecular markers for esophageal carcinoma.
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