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This article has reviewed the current role of radiation in the treatment of gastrointestinal malignancies and discussed the data supporting its use. Radiation treatment in this setting continues to evolve with the increasing implementation of more conformal delivery techniques. Further scientific investigation is needed to establish the optimal role of radiation and to better define its integration with novel systemic and biologic modalities.

Quality of life (QOL) endpoints are assuming an increasing role in clinical oncology trials. This article reviews the definition of QOL and the importance of measuring QOL in oncology trials. The optimal choice, timing, and frequency of QOL instruments are summarized. Methodologic issues are also reviewed, including the statistical interpretation of QOL data. Finally, the Radiation Therapy Oncology Group clinical outcomes triad model is described. Future QOL studies must focus on randomized trials with dear hypotheses that can lead to clinically meaningful interventions.