One hundred and one consecutive patients with oesophageal
cancer,
cancer of the cardia and
gastric cancer extending upwards from the stomach to the oesophagus were treated from 1979 to 1985 with a policy that included
radiotherapy treatment for 58. This heterogeneous group, which was considered together as oesophageal
cancer, was subdivided according to anatomical location, histology and pretreatment staging. Those patients who could be treated surgically by a resection and anastomosis performed below the diaphragm were excluded. Thirty-five had surgery which was either an oesophagogastrectomy or oesophagojejunostomy with an intrathoracic anastomosis, except for two who were nonresectable. Eight patients were to ill or refused treatment. The role of
radiotherapy was assessed in three groups: i. Operable
squamous cell carcinoma of the oesophagus was treated by radical
radiotherapy (22) with a 46% 1-year and 14% 5-year survival. ii. Inoperable
squamous cell carcinoma of the oesophagus was given radical or palliative
radiotherapy (25) with a 16% 1-year and 4% 5-year survival. iii. Non-resectable
adenocarcinoma of the stomach or oesophagus was treated palliatively by
radiotherapy to debulk the intraluminal tumour (11), all of whom had symptomatic relief of
dysphagia. The results of radical
radiotherapy for operable
squamous cell carcinoma of the oesophagus were similar to the best results achieved by surgical resection in other series in which there is comparable staging.
Radiotherapy should be included in the treatment options for oesophageal
cancer.