Radiation Therapy for Esophageal Cancer

When radiation therapy is part of the treatment for esophageal cancer, it is often given along with chemotherapy — in a treatment called chemoradiation — before surgery to improve the outcome of surgical treatment. If surgery is done initially, some patients may need radiation therapy afterwards. Radiation therapy may also be used as palliative care to ease cancer symptoms.

Radiation therapy for esophageal cancers may be delivered in different ways, including:

• External Beam Radiation Therapy (EBRT): This is the most common method of delivering radiation for treatment of esophageal cancer. Radiation is usually delivered over 25 to 28 treatments and can be done in several ways, each with their own advantages.
• 3-Dimensional Conformal Radiation Therapy (3D CRT): This is a form of EBRT where a few shaped radiation beams are aimed at the cancer target from different directions.
• Volumetric Modulated Arc Therapy (VMAT): A more precise form of EBRT than 3D CRT where the radiation dose is given and the field shape is changed continuously as the treatment machine moves, or arcs, around the patient. This treatment helps to spare more normal tissue.
• Stereotactic Body Radiation Therapy (SBRT): This is similar to VMAT in that it is planned with great precision, but the difference is that the entire radiation dose is given over a fewer number of treatments, typically about five.

Roswell Park’s radiation medicine team goes to great lengths to achieve the necessary precision needed to target the cancer while protecting normal tissue and organs, including the gating technique which holds the patient still and reduces movement from breathing.