Chemoradiation for Esophageal Cancer

Esophageal cancer management is based on baseline clinical stage, location of the tumor, and associated comorbid conditions. In patients with localized esophageal cancer (LEC) with technically resectable tumors and who are medically fit for surgery, the current recommendation is trimodality therapy (chemoradiation followed by surgery). Bimodality therapy (definitive chemoradiation) is reserved for patients with cervical esophageal tumors, technically unresectable tumors, for patients who cannot be recommended surgery due to medical comorbidities, or those who decline surgery. Prospective data from 2 studies suggest that definitive chemoradiation may be sufficient for LEC with squamous cell histology; a definite answer, however, is unclear.