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<p>With the development of modern techniques, intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and image-guided and adaptive radiotherapy (IGRT and ART), modern radiotherapy of esophageal cancer has become a&#xa0;well-tolerated treatment modality that can also be used for the elderly with greater precision and optimized conformity. Normal tissue, especially the heart and lungs, is carefully considered during treatment planning. In combination with chemotherapy, radiotherapy is a&#xa0;potentially curative treatment option for functionally inoperable patients and for surgically or endoscopically unresectable esophageal cancer. The indication for radiochemotherapy should be made by an experienced, interdisciplinary team after considering all therapeutic alternatives. The frequency of complete clinical remission after definitive radiochemotherapy ranges between 30% and 55%. Post-therapeutic supportive measures can be of decisive importance for quality of life. Further increases in the effectiveness of radiochemotherapy at a&#xa0;dose of 50.4 Gy with conventional fractionation are expected through sequential or simultaneous immunotherapy with immune checkpoint inhibitors and further optimization of the chemotherapy component.</p>

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Definitive Radiochemotherapie des Ösophaguskarzinoms: etablierte Therapie und neue Standards

  • 期刊论文

  • 发表日期：

    2025年1月6日

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  • N. Guberina,
  • M. Guberina,
  • Y. Alberti,
  • M. Stuschke

摘要

With the development of modern techniques, intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and image-guided and adaptive radiotherapy (IGRT and ART), modern radiotherapy of esophageal cancer has become a well-tolerated treatment modality that can also be used for the elderly with greater precision and optimized conformity. Normal tissue, especially the heart and lungs, is carefully considered during treatment planning. In combination with chemotherapy, radiotherapy is a potentially curative treatment option for functionally inoperable patients and for surgically or endoscopically unresectable esophageal cancer. The indication for radiochemotherapy should be made by an experienced, interdisciplinary team after considering all therapeutic alternatives. The frequency of complete clinical remission after definitive radiochemotherapy ranges between 30% and 55%. Post-therapeutic supportive measures can be of decisive importance for quality of life. Further increases in the effectiveness of radiochemotherapy at a dose of 50.4 Gy with conventional fractionation are expected through sequential or simultaneous immunotherapy with immune checkpoint inhibitors and further optimization of the chemotherapy component.