[Principles of treatment in locally advanced esophageal squamous cancer]

The diagnosis established in the symptomatic phase of this disease, most often occurs at advanced stage neoplasia. The purpose of this article is to establish the place and method of surgical and radio-chemo therapy in advanced loco-regional squamous esophageal neoplasm (stage IIB-III). Surgical treatment establishes the best results over long periods of time, however, this is done keeping in mind acceptable morbidity and mortality conditions. Multimodal treatment is encompassed in general efforts to achieve optimal results along with increasing the quantity and quality of life. Neoadjuvant radiochemotherapy (CRT) increases practitioners' possibility of resecting tumors, decreasing their size, and establishing proper means of local (radiotherapy) and systemic (chemotherapy) control. Great efforts are made in finding markers which lead to correct diagnosis and treatment options that will further permit nonresponsive radio and chemo therapy treated patients from experiencing unwanted toxicity. The role of adjuvant therapy is that of decreasing recurrence in patients with residual mediastinal disease after palliative surgical resection. Palliative treatment consists of improving dysphagia, and the quality of life using surgical, endoscopic, photodynamic, laser, radio and chemotherapy as alternatives.