Chemoradiotherapy and Radiotherapy for Oesophageal Cancer in the UK: Current Practice and Future Directions: An...

Bleaney et al 2025 have shown there is widespread variation in UK oesophageal radiotherapy practice (1). This variation is in all stages of the radiotherapy pathway and brings into focus the need for a concise summary of current best practice. An attempt to summarise best practice and priorities for research was published in 2013 by Gwynne et al. (2). In this article, developments in oesophageal radiotherapy in the UK over the past decade are summarised and current best practice is reviewed. The role of radiotherapy in oesophageal cancer management and aspects of radiotherapy planning from target volume delineation to motion management, image-guided radiotherapy, choice of organs at risk dose constraints, and use of protons are examined. This includes the opportunity to discuss potential areas of development that may become standard clinical practice in the next 5-10 years, for example, adaptive radiotherapy, the integration of magnetic resonance imaging (MRI), and the use of moderate hypofractionation. The importance of quality assurance and imaging for response assessment are reviewed, and priorities for future research are determined. With an established track record of high-quality UK oesophageal RT trials, the UK upper gastrointestinal clinical oncology community is well placed to develop new trials and further improve outcomes for oesophageal cancer patients, and this article summarises current best practice and research priorities for oesophageal radiotherapy in the UK.