TY - JOUR
T1 - Multiple Management Modalities in Esophageal Cancer
T2 - Combined Modality Management Approaches
AU - Koshy, Mary
AU - Esiashvilli, Natia
AU - Landry, Jerome C.
AU - Thomas, Charles R.
AU - Matthew, Richard H.
PY - 2004/4/20
Y1 - 2004/4/20
N2 - The overall success rate nationally in treating esophageal carcinomas remains poor, with over 90% of patients succumbing to the disease. In part I of this two-part series, we explored epidemiology, presentation and progression, work-up, and surgical approaches. In part II, we explore the promising suggestions of integrating chemotherapy and radiation therapy into the multimodal management of esophageal cancers. Alternative approaches to resection alone have been sought because of the overall poor survival rates of esophageal cancer patients, with failures occurring both local-regionally and distantly. Concomitant chemotherapy and radiation therapy (XRT) have been shown, by randomized trial, to be more effective than XRT alone in treating unresectable esophageal cancers and also have shown promise as a neoadjuvant treatment when combined with surgery in the multimodal treatment of this disease. Various studies have also addressed issues such as preoperative chemotherapy, radiation dose escalation, chemotherapy/XRT as a definitive treatment versus use as a surgical adjuvant, and alternative chemotherapy regimens. There are suggestions of some progress, but this remains a difficult problem area in which management is continuing to evolve.
AB - The overall success rate nationally in treating esophageal carcinomas remains poor, with over 90% of patients succumbing to the disease. In part I of this two-part series, we explored epidemiology, presentation and progression, work-up, and surgical approaches. In part II, we explore the promising suggestions of integrating chemotherapy and radiation therapy into the multimodal management of esophageal cancers. Alternative approaches to resection alone have been sought because of the overall poor survival rates of esophageal cancer patients, with failures occurring both local-regionally and distantly. Concomitant chemotherapy and radiation therapy (XRT) have been shown, by randomized trial, to be more effective than XRT alone in treating unresectable esophageal cancers and also have shown promise as a neoadjuvant treatment when combined with surgery in the multimodal treatment of this disease. Various studies have also addressed issues such as preoperative chemotherapy, radiation dose escalation, chemotherapy/XRT as a definitive treatment versus use as a surgical adjuvant, and alternative chemotherapy regimens. There are suggestions of some progress, but this remains a difficult problem area in which management is continuing to evolve.
KW - Esophageal carcinoma
KW - Multimodal treatment
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=1842452788&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=1842452788&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.9-2-147
DO - 10.1634/theoncologist.9-2-147
M3 - Review article
C2 - 15047919
AN - SCOPUS:1842452788
VL - 9
SP - 147
EP - 159
JO - Oncologist
JF - Oncologist
SN - 1083-7159
IS - 2
ER -