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Titolo:
Perioperative radiotherapy for cancer of the esophagus
Autore:
Wenz, F; Mamon, H;
Indirizzi:
Univ Heidelberg, Klinikum Mannheim, Dept Radiat Oncol, D-68167 Mannheim, Germany Univ Heidelberg Mannheim Germany D-68167 ncol, D-68167 Mannheim, Germany
Titolo Testata:
SEMINARS IN SURGICAL ONCOLOGY
fascicolo: 1, volume: 20, anno: 2001,
pagine: 33 - 39
SICI:
8756-0437(200101/02)20:1<33:PRFCOT>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
SQUAMOUS-CELL CARCINOMA; POSTOPERATIVE RADIATION-THERAPY; PATIENTS RECEIVING RADIATION; RANDOMIZED CLINICAL-TRIAL; PREOPERATIVE RADIOTHERAPY; GASTROESOPHAGEAL JUNCTION; 1992-1994 PATTERNS; MULTIMODAL THERAPY; THORACIC ESOPHAGUS; CURATIVE RESECTION;
Keywords:
esophageal neoplasms; radiotherapy; adjuvant radiotherapy; neoadjuvant therapy; combined modality therapy; prognosis; survival rate;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Wenz, F Univ Heidelberg, Klinikum Mannheim, Dept Radiat Oncol, Theodor Kutzer Ufer1-3, D-68167 Mannheim, Germany Univ Heidelberg Theodor Kutzer Ufer 1-3 Mannheim Germany D-68167
Citazione:
F. Wenz e H. Mamon, "Perioperative radiotherapy for cancer of the esophagus", SEM SURG ON, 20(1), 2001, pp. 33-39

Abstract

Carcinomas of the esophagus represent on average about 1% to 2% of all malignant tumors. The incidence shows extreme regional differences, reflectingthe established environmental and acquired risk factors for cancer of the esophagus. There has been a major shift in tumor location and histology over the last decades, with the lower third/gastroesophageal junction becomingthe most common location and adenocarcinoma the most common histology in white males. There has been a striking improvement in surgical resection rates and operative mortality; however, the curative potential of surgery is likely to be highest in early-stage disease. The poor prognosis for locally advanced tumors motivated the search for multimodal approaches to improve results. While neither perioperative radiotherapy nor perioperative chemotherapy alone have significantly improved survival rates, combined radiochemotherapy, used as neoadjuvant or definitive therapy, appears more promising. For patients with advanced tumors or extensive nodal involvement, first principles and extrapolation from other tumors of the gastrointestinal tract suggest that a combination of chemotherapy and radiation is likely to be of benefit, as compared to surgery alone. As this treatment is difficult to tolerate in the postoperative setting, neoadjuvant approaches have been emphasized. Although there are promising data, and preoperative chemoradiation is widely utilized, we do not consider the benefit of this approach to have been proven unequivocally. Future progress in the treatment of esophageal cancer may require that systemic therapy be improved to the point where occult metastatic disease can be controlled, enabling the local control provided by surgery and radiation to lead to improved survival. (C) 2001 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/02/20 alle ore 22:01:18