• Various combinations of chemotherapy , radiation and surgery may be attempted. Radiation and
chemotherapy without surgery is being evaluated for patients who are inoperable, have refused surgery or are
over 80 years old.
• 5-FU + interferon-alpha has shown significant activity.
• One study showed improved survival for patients with non-resectable tumors if radiation, chemotherapy and
heat treatments (hyperthermia) were given after part of the esophagus was removed.
• Laser therapy may be used to reduce obstruction (photodynamic protoporphyrin therapy and dilation).
Patients with severe weight loss or anorexia are generally poor risks for therapy.
Stage IV
TNM Any T, any N, M1
The tumor has spread to other organs (distant metastases).
Standard Treatment There is no standard treatment for Stage IV esophageal cancer. Standard palliative approaches—including external radiation with chemotherapy, with or without the insertion of an eating tube and dilation—are used. All patients may be considered candidates for investigational protocols evaluating new approaches to treatment, including promising chemotherapy combinations.
