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14-02-2017 | Esophageal cancer | Book chapter | Article

4. Esophageal Cancer: Radiation Therapy Planning

Authors: MD, PhD Matthew J. Boyer, MD Christopher G. Willett, MD Manisha Palta, MD Brian G. Czito

Publisher: Springer International Publishing


The treatment of esophageal cancer with radiation therapy presents many challenges. The propensity of esophageal cancer to invade and spread within the submucosa with resultant lymph node involvement requires particular attention to areas of elective coverage beyond the gross tumor. Moreover, the intimate association of the esophagus and gastroesophageal junction with adjacent organs in the thoracic cavity and upper abdomen dictates attention to normal tissue constraints. Although most patients receive preoperative chemoradiation, patients treated postoperatively may require larger treatment fields, further increasing treatment-related normal tissue toxicities. This chapter will discuss the rationale of radiation treatment field design and dose for esophageal cancer patients based on thoracic anatomy, imaging, and patterns of spread/failure, as well as practical considerations for patient simulation and treatment.

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