TY - JOUR AU - Haque, Waqar AU - Butler, E. Brian AU - Teh, Bin S. PY - 2019 TI - Neoadjuvant radiation therapy for esophageal cancer: is a higher dose better? JF - Journal of Thoracic Disease; Vol 11, No 12 (December 31, 2019): Journal of Thoracic Disease Y2 - 2019 KW - N2 - Neoadjuvant chemoradiation (CRT) is currently a standard of care for locally advanced esophageal cancer (1). The data supporting the efficacy of neoadjuvant CRT over surgery alone is supported by multiple randomized trials, the largest of which was the CROSS trial, which showed that for patients with locally advanced esophageal cancer, treatment with 41.4 Gy in 23 fractions with concurrent Carboplatin/Taxol results in improved overall survival (OS) when compared to treatment with surgery alone (2). The CALGB 9781 trial randomized patients to neoadjuvant treatment with 50.4 Gy in 28 fractions with concurrent cisplatin and fluouracil or surgery alone, and demonstrated superior OS in the group of patients receiving neoadjuvant treatment, but this trial closed early due to poor accrual (3). Other randomized trials have used neoadjuvant radiation therapy (RT) doses between 35–50 Gy along with chemotherapy with varying results (4-6). Therefore, the optimal neoadjuvant RT dose is a matter of debate, and the current NCCN Guidelines recommend a radiation dose of 41.4–50.4 Gy. UR - https://jtd.amegroups.org/article/view/34011