Chemotherapy for esophageal cancer;should it be offered to all patients?

Abstract

Esophageal cancer presents a rising incidence worldwide with
poor outcome in most of the cases. The traditional approach
has been esophagectomy for surgically respectable tumors and
palliative treatment for unresectable tumors. During the last
years several studies reported that preoperative radiochemotherapy
increased the complete surgical resection rate and local
regional control but without a significant survival benefit.
However, radiochemotherapy followed by surgery is associated
with significant dosing-related adverse effects. The present
review provides an overview of the management of esophageal
cancer with particular emphasis on locally advanced disease
which remains an area of controversy regarding the clinical
impact of preoperative chemotherapy.
Key words: esophageal cancer; chemotherapy; radiotherapy;
ethics;