Radiotherapy for cancers of the oesophagus, cardia and stomach.
Cancer Radiother
; 26(1-2): 250-258, 2022.
Article
en En
| MEDLINE
| ID: mdl-34955417
ABSTRACT
We present the updated recommendations of the French society for radiation oncology on radiotherapy of oesophageal cancer. Oesophageal cancer still remains a malignant tumour with a poor prognosis. Surgery remains the standard treatment for localized cancers, regardless of histology. For locally advanced stages, surgery remains a standard for adenocarcinomas after neoadjuvant treatment with chemotherapy or chemoradiotherapy. However, it is a therapeutic option after initial chemoradiotherapy for stage III squamous cell carcinomas, given the increased morbidity and mortality with a multimodal treatment, which results in an equivalent overall survival with or without surgery. Preoperative or exclusive chemoradiotherapy should be delivered according to validated regimens with an effective total dose (50Gy), if surgery is not planned or if the tumour is deemed resectable before chemoradiotherapy. Intensity-modulated radiotherapy significantly reduces irradiation of the lungs and heart and may reduce the morbidity of this treatment, especially in combination with surgery. In case of exclusive chemoradiotherapy, dose escalation beyond 50Gy is not currently recommended. Some technical considerations still remain questionable, such as the place of prophylactic lymph node irradiation, adaptive radiotherapy, evaluation of response during and after chemoradiotherapy and the value of proton therapy.
Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Gástricas
/
Neoplasias Esofágicas
/
Carcinoma de Células Escamosas
/
Cardias
/
Adenocarcinoma
Tipo de estudio:
Guideline
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Cancer Radiother
Asunto de la revista:
NEOPLASIAS
/
RADIOTERAPIA
Año:
2022
Tipo del documento:
Article