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Related Experiment Videos

Esophageal cancer

L R Coia1, E R Sauter

  • 1Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111.

Current Problems in Cancer
|July 1, 1994
PubMed
Summary
This summary is machine-generated.

Esophageal cancer survival rates are low, but chemoradiation shows promise. This multimodality therapy, combining chemotherapy and radiation, offers improved survival and palliation for esophageal cancer patients.

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Area of Science:

  • Oncology
  • Gastroenterology
  • Cancer Research

Background:

  • Esophageal cancer is a significant cause of cancer deaths in the US, with a rising incidence of adenocarcinoma.
  • The exact reasons for the increasing incidence of esophageal adenocarcinoma are not well understood.
  • Several tumor-suppressor genes and proto-oncogenes are implicated in esophageal cancer development.

Purpose of the Study:

  • To review the current understanding of esophageal cancer, including its incidence, contributing factors, and prognostic indicators.
  • To evaluate the effectiveness of various treatment modalities, including surgery, radiation, chemotherapy, and multimodality therapy.
  • To discuss newer endoscopic techniques for palliation of advanced esophageal cancer.

Main Methods:

  • Review of clinical prognostic factors such as stage, performance status, and patient demographics.

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  • Evaluation of surgical resection, adjuvant radiation, and neoadjuvant chemotherapy.
  • Analysis of multimodality therapy, specifically concurrent chemoradiation, as a primary treatment approach.
  • Assessment of newer endoscopic palliative techniques.

    • Main Results:

    • Surgical resection alone offers a limited cure rate (10-20%) but provides palliation.
    • Adjuvant radiation or neoadjuvant chemotherapy has not significantly improved survival.
    • Concurrent chemoradiation prior to surgery shows promise, with one study reporting a 5-year survival of 34%.
    • Complete pathologic response to chemoradiation correlates with improved survival.
    • Chemoradiation is superior to radiation alone and is a viable alternative to esophagectomy for squamous cell carcinoma and adenocarcinoma.

    Conclusions:

    • Chemoradiation is a promising treatment for esophageal cancer, offering improved survival and palliation.
    • Further randomized trials are needed to compare chemoradiation with surgery and other treatment regimens.
    • Endoscopic techniques offer valuable palliative options for advanced esophageal cancer.