Chemoradiation therapy in the management of gastrointestinal malignancies

Autumn J. McRee, Stacy Cowherd, Andrew Z. Wang, Richard M. Goldberg

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Concurrent administration of chemotherapy and radiotherapy has been increasingly used in cancer treatment, leading to improvements in survival as well as quality of life. Currently, it is a feasible preference, often regarded as the standard therapeutic option, for many locally confined solid tumors, including anal, bladder, cervical, esophageal, gastric, head and neck, lung, pancreatic and rectal cancers. In patients with these tumors, combined modality therapy improves local tumor control and survival while, in some instances, obviating the need for surgical removal of the organ of origin. The scientific rationale for the use of chemoradiation derives from the preclinical and clinical observations of synergistic interactions between radiotherapy and chemotherapy. When chemotherapy and radiotherapy are administered together, the chemotherapeutic agents can sensitize the cancer cells to the effects of ionizing radiation, leading to increased tumor-killing effects within the radiotherapy field. This, in turn, can improve local control of the primary tumor and, in some cancers, render surgical resection unnecessary. In other cases, patients with tumors that were initially considered unresectable are able to undergo curative interventions after completing chemoradiation. The chemotherapy component can address any potential micrometastatic disease that, without therapy, leads to an increased risk of distant recurrence. A large body of evidence exists that supports the use of chemoradiotherapy in gastrointestinal cancers. In fact, one of the first tumor types in which the superior efficacy of chemoradiation was described was anal cancer. Since then, chemoradiotherapy has been explored in other gastrointestinal malignancies with superior outcomes when compared with either radiation or chemotherapy alone. This article aims to recapitulate the clinical evidence supporting the use of chemoradiotherapy in a variety of gastrointestinal tumor types.

Original languageEnglish (US)
Pages (from-to)409-426
Number of pages18
JournalFuture Oncology
Volume7
Issue number3
DOIs
StatePublished - Mar 2011
Externally publishedYes

Keywords

  • anal cancer
  • chemoradiation therapy
  • esophageal cancer
  • gastric cancer
  • pancreatic cancer
  • rectal cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint

Dive into the research topics of 'Chemoradiation therapy in the management of gastrointestinal malignancies'. Together they form a unique fingerprint.

Cite this