THE VALUE OF RADIOTHERAPY IN THE MANAGEMENT OF ESOPHAGEAL CANCER

The surgical management of carcinoma of the cervical and upper thoracic esophagus is not entirely satisfactory. Unless the surgeon is so highly selective that his method of treatment hardly amounts to a serious contribution to the over-all management of the disease, the operative mortality is high. For a patient to die as a result of the method of treatment is a tragedy, tolerable only if balanced by a very appreciable expectation of cure. No present available method of treatment cures more than 20 per cent of an appreciable proportion of the patients developing this disease. Judging by the Edinburgh experience, after megavoltage irradiation, although local failure is common, the expectation of long survival is better than it is after operation. The main reason for this difference is the absence of treatment mortality following irradiation.For carcinoma of the lower thoracic esophagus, surgery is quite frequently successful and of proved value in a large series of patients. At this level radiotherapy has ...