Esophagus cancer

The location of the esophagus in the central mediastinum makes proton therapy an appealing option for the bi- or trimodality treatment of esophageal cancer (EC). Proton therapy has dosimetric advantages over three-dimensional (3D) conformal or intensity-modulated radiation therapy, but evidence from both treatment plan comparisons and clinical studies in EC is not sufficiently mature to allow identification of patients who are more (or less) likely to benefit from proton therapy. This chapter reviews issues associated with target delineation and treatment planning for proton therapy, summarizes the dosimetric and clinical outcomes-based evidence published to date, and suggests directions for future research.