Combined-modality treatment of esophageal cancer.

The use of chemotherapy and radiotherapy prior to surgery for patients with potentially resectable esophageal carcinoma has been investigated since the late 1970s, with trials yielding response rates approaching 50%. Although some of these trials suggested improved survival with preoperative chemoradiation plus surgery, as compared with historical controls treated with surgery or radiation alone, the question of survival benefit had to be addressed in prospective, randomized fashion. This review describes the experience with surgery or radiation alone vs preoperative chemoradiation in terms of long-term overall survival in the treatment of esophageal cancer.