1. Radiotherapy for cancers of the oesophagus, cardia and stomach.
- Author
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Créhange G, Modesto A, Vendrely V, Quéro L, Mirabel X, Rétif P, and Huguet F
- Subjects
- Adenocarcinoma mortality, Adenocarcinoma pathology, Adenocarcinoma therapy, Brachytherapy methods, Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell therapy, Chemoradiotherapy methods, Esophageal Neoplasms mortality, Esophageal Neoplasms pathology, Esophageal Neoplasms therapy, France, Humans, Lymphatic Irradiation, Neoadjuvant Therapy methods, Patient Positioning methods, Radiation Oncology, Radiotherapy Dosage, Radiotherapy, Image-Guided, Radiotherapy, Intensity-Modulated methods, Adenocarcinoma radiotherapy, Carcinoma, Squamous Cell radiotherapy, Cardia, Esophageal Neoplasms radiotherapy, Stomach Neoplasms radiotherapy
- 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., (Copyright © 2021 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2022
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