Multimodal therapy concepts in oesophageal carcinoma: importance of radio-and chemotherapy

Five-year survival of surgically treated patients with operable oesophageal carcinoma does not exceed 20%. The results with curative radiotherapy are even worse, with less than or equal to 10% alive after 5 years. New treatme nt strategies are needed. Pre- or postoperative radiotherapy and perioperat ive chemotherapy alone do not improve survival. A simultaneous radiochemoth erapy with cisplatin is significantly more effective than radiotherapy alon e. A subgroup of patients with pathological complete remission after preope rative treatment (radio- and/or chemotherapy) survives significantly longer . It seems likely that survival in oesophageal cancer is improved by multim odal therapy encompassing radiotherapy, chemotherapy and surgery. Further r andomised trials are needed, possibly in combination with other potentially active drugs.