External beam radiation therapy may be palliative for larger tumors or with celiac lymph node involvement (for the lower esophagus) and supraclavicular lymph node involvement (for the upper esophagus).
A radiation source (iridium) may be inserted into the esophagus and left at the tumor site for several hours (intraluminal brachytherapy). Side effects can include inflammation of the esophagus (but rarely the heart or spinal cord), bleeding or a hole from the esophagus into the lungs (esophagobronchial fistula). This may also happen as part of the disease process, especially for the middle third of the esophagus.
Five-Year Survival 10 to 15 percent
Investigational
• Radiation therapy given for two weeks before surgical removal of the esophagus may eliminate some of the
tumor cells that have spread and make some inoperable tumors operable.
• There are several trials being conducted using combinations of chemotherapy (5-FU and cisplatin) and
radiosensitizers along with radiation before or after surgery.
• Various chemotherapy programs to increase resectability are being evaluated. Chemotherapy may not increase
the number of tumors that are operable, but those who respond to chemotherapy live longer than those who
