Vosmik M, Petera J, Sirak I, Hodek M, Paluska P, Dolezal J, Kopacova M. Technological advances in radiotherapy for esophageal cancer. World J Gastroenterol 2010; 16(44): 5555-5564 [PMID: 21105188 DOI: 10.3748/wjg.v16.i44.5555]
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Milan Vosmik, MD, PhD, Department of Oncology and Radiotherapy, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Teaching Hospital in Hradec Kralove, Sokolska 581, 50005 Hradec Kralove, Czech Republic. vosmik@fnhk.cz
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World J Gastroenterol. Nov 28, 2010; 16(44): 5555-5564 Published online Nov 28, 2010. doi: 10.3748/wjg.v16.i44.5555
Technological advances in radiotherapy for esophageal cancer
Milan Vosmik, Jiri Petera, Igor Sirak, Miroslav Hodek, Petr Paluska, Jiri Dolezal, Marcela Kopacova
Milan Vosmik, Jiri Petera, Igor Sirak, Miroslav Hodek, Petr Paluska, Department of Oncology and Radiotherapy, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Teaching Hospital in Hradec Kralove, 50005 Hradec Kralove, Czech Republic
Jiri Dolezal, Department of Nuclear Medicine, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Teaching Hospital in Hradec Kralove, 50005 Hradec Kralove, Czech Republic
Marcela Kopacova, 2nd Department of Medicine, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Teaching Hospital in Hradec Kralove, 50005 Hradec Kralove, Czech Republic
Author contributions: Vosmik M, Petera J, Sirak I, Hodek M, Paluska P, Dolezal J and Kopacova M contributed equally to this paper.
Supported by Research Project of the Ministry of Health of Czech Republic MZO 00179906
Correspondence to: Milan Vosmik, MD, PhD, Department of Oncology and Radiotherapy, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Teaching Hospital in Hradec Kralove, Sokolska 581, 50005 Hradec Kralove, Czech Republic. vosmik@fnhk.cz
Telephone: +420-49-5832176 Fax: +420-49-5832081
Received: March 10, 2010 Revised: May 25, 2010 Accepted: June 2, 2010 Published online: November 28, 2010
Abstract
Radiotherapy with concurrent chemotherapy and surgery represent the main treatment modalities in esophageal cancer. The goal of modern radiotherapy approaches, based on recent technological advances, is to minimize post-treatment complications by improving the gross tumor volume definition (positron emission tomography-based planning), reducing interfraction motion (image-guided radiotherapy) and intrafraction motion (respiratory-gated radiotherapy), and by better dose delivery to the precisely defined planning target volume (intensity-modulated radiotherapy and proton therapy). Reduction of radiotherapy-related toxicity is fundamental to the improvement of clinical results in esophageal cancer, although the dose escalation concept is controversial.
