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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2015; 7(1): 1-5
Published online Jan 15, 2015. doi: 10.4251/wjgo.v7.i1.1
Role of radiotherapy in the pre-operative management of carcinoma of the esophagus
Bryan H Burmeister
Bryan H Burmeister, Division of Cancer Services, Princess Alexandra Hospital, University of Queensland, Brisbane 4012, Australia
Author contributions: Burmeister BH solely contributed to this manuscript.
Conflict-of-interest: I have no other conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bryan H Burmeister, MD, Division of Cancer Services, Princess Alexandra Hospital, University of Queensland, 199 Ipswich Road, Brisbane 4102, Australia. bryan.burmeister@health.qld.gov.au
Telephone: +61-7-31766581 Fax: +61-7-31761983
Received: June 30, 2014
Peer-review started: June 30, 2014
First decision: October 28, 2014
Revised: December 16, 2014
Accepted: December 29, 2014
Article in press: December 31, 2014
Published online: January 15, 2015
Abstract

The use of radiotherapy in the management of carcinoma of the esophagus and gastro-esophageal junction has undergone much evolution over the past 2 decades. Advances to define its role have been slow with meta-analyses often providing the most useful data. In spite of this many institutions around the world are divided about the role of radiotherapy in this disease and attribute different roles to radiotherapy based on clinical stage, tumor site and histology. The purpose of this review is to try to define the role of radiotherapy given our current knowledge base and to review which current and future trials may fill the gaps of knowledge that we currently have. It will also highlight the difficulties in making firm recommendations about the use of radiotherapy especially in a time when technology and treatments are rapidly evolving.

Keywords: Esophageal cancer, Preoperative therapy, Neoadjuvant therapy, Chemoradiotherapy, Surgery

Core tip: This review describes the history and develop-ment of radiotherapy in the pre-operative setting for resectable esophageal cancer. In particular it focuses on data from multicenter phase II and phase III trials as well as meta-analyses from across the world. The review concludes with a discussion about the role of new radiation technologies in the management of esophageal cancer.