Radiation Therapy

Radiation Therapy for Esophageal Cancer

by Ricker Polsdorfer, MD

Radiation therapy uses high energy x-rays to destroy cancer cells. Special tools and dosing will help to kill as much of the cancer as possible while sparimg healthy tissue. A radiation oncologist will customize the treatment dose for individual needs.

For esophageal cancer, radiation therapy is most often used along with chemotherapy. The combination is often more effective than either treatment alone.

Radiation therapy may be used:

Before surgery to shrink the tumor and decrease the amount of tissue that has to be removed
After surgery to kill any remaining cancer
For tumors that have spread to relieve symptoms and extend survival time

Types of radiation therapy used for esophageal cancer include:

External Beam Radiation

A machine directs high-energy rays through the body and into the tumor. The size of the tumor, surrounding tissue, and type of cancer will affect treatment details. The radiation oncologist will talk about how much radiation will be given and how often. The goal is to deliver the highest amount of radiation to the cancer.

The therapy is often given in a number of doses over a few weeks. You can go home in between treatments.

Brachytherapy

This is also called internal radiation therapy. Radioactive material is placed in a special container. The container is then placed near the tumor. This allows a higher dose of radiation to be delivered directly to the tumor. It is generally used to treat tumors that are blocking the esophagus. The material is placed with an endoscopy. A scope is passed down the throat to the tumor. Brachytherapy may be:

Low-dose—Radiation is left in place for 1 to 2 days. A hospital stay will be needed. It can be one in 1 to 2 cycles.
High-dose—Radiation is left in for a few minutes at a time. Because of this, more cycles are needed.

Side Effects and Management

Complications of radiation therapy to the chest and abdominal areas may include:

Difficulty or pain when swallowing
Narrowing of the esophagus—esophageal stricture
An abnormal opening between 2 structures—fistula
Lung damage
Shortness of breath

Treatments can help to manage side effects. Dry, irritated skin, nausea, vomiting, diarrhea, and fatigue due to anemia can all occur. Adjustments may be made to treatment. The earlier side effects are addressed, the more likely they will be controlled.

References:

Esophageal and esophagogastric junction cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated June 25, 2018. Accessed December 31, 2018.

Esophageal cancer. Merck Manual Professional Version website. Available at:
...(Click grey area to select URL)
Updated October 2017. Accessed December 31, 2018.

Esophagus cancer. American Cancer Society website. Available at
...(Click grey area to select URL)
Accessed December 31, 2018.

General information about esophageal cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/esophageal/patient/esophageal-treatment-pdq#section/all. Updated September 7, 2018. Accessed December 31, 2018.

Last reviewed December 2018 by Mohei Abouzied, MD
Last Updated: 12/31/2018

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