The Role of Radiotherapy in Localized Esophageal and Gastric Cancer

Multimodality management has become a core treatment principle for locally advanced esophageal, gastroesophageal junction (GEJ), and gastric cancer. Radiotherapy serves an important role for optimizing patient outcomes. This article reviews the evolving role of radiotherapy in the multidisciplinary management of esophageal, GEJ, and gastric cancer, summarizing the results of recent clinical trials leading to contemporary accepted treatment approaches. A major theme is the evidence supporting the role of radiotherapy in combined modality management, particularly the trend toward its delivery in the neoadjuvant setting. Also reviewed are novel radiotherapy paradigms and newer radiation technologies such as image-guided radiotherapy and MRI-guided radiotherapy.