About chemoradiotherapy

Treatment with chemotherapy and radiotherapy together is called chemoradiotherapy. You might have this treatment for oesophageal cancer

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

Radiotherapy uses high energy x-rays to treat cancer cells.

Giving these treatments together can cure some early stage oesophageal cancers. Chemoradiotherapy can also shrink a cancer before surgery to make it easier to remove.

When do you have chemoradiotherapy?

Your treatment plan depends on how far your cancer has grown (the stage), what type of oesophageal cancer you have (adenocarcinoma or squamous cell cancer) and how well you are.

Chemoradiotherapy as your main treatment

You might have chemoradiotherapy instead of surgery if you have a squamous cell cancer that hasn't spread. The doctors keep a close eye on you after the treatment. This is called active surveillance. 

Chemoradiotherapy before surgery

You might have chemoradiotherapy before surgery if you have adenocarcinoma or squamous cell cancer which hasn't spread to other parts of your body. This is called neoadjuvant chemoradiotherapy. It shrinks the cancer and makes it easier to remove.

Chemoradiotherapy instead of surgery

You might have other health conditions that mean you're not well enough to have surgery. Or you might not be able to have surgery because the cancer has grown into nearby tissues. The doctor might offer you chemoradiotherapy instead.

What chemotherapy will I have?

There are different chemotherapy drugs that doctors can combine with radiotherapy.

The most common drugs to combine with radiotherapy are cisplatin and capecitabine (Xeloda). You might start the chemotherapy before the radiotherapy starts. You continue to have it during the radiotherapy treatment.

You have:

  • capecitabine as tablets twice a day throughout your treatment
  • cisplatin chemotherapy as a drip into your arm once every 3 weeks

There are other chemotherapy drugs you might have instead of capecitabine and cisplatin, including:

  • fluorouracil (5FU) instead of capecitabine
  • oxaliplatin or carboplatin instead of cisplatin

Doctors also sometimes combine the chemotherapy drugs carboplatin and paclitaxel with radiotherapy. You might have this if you are having chemoradiotherapy before surgery.

You usually have treatment in the chemotherapy day unit or you might need to stay in hospital overnight.

Radiotherapy treatment

You have radiotherapy in short sessions every weekday for about 4 to 6 weeks. You have it in the hospital radiotherapy department.

Before you begin treatment, the radiotherapy team work out how much radiation you need. They divide it into a number of smaller treatments. They call each treatment a fraction. At your planning appointment the radiographers might make pen marks or small tattoos on your skin in the treatment area.

Your treatment starts a few days or up to 3 weeks after the planning session. You have radiotherapy from an external machine as a daily treatment, five days a week for between 4 and 6 weeks.

Side effects

  • Oesophago-gastric cancer: assessment and management in adults  [NG83]
    National Institute for Health and Clinical Excellence (NICE)
    Published January 2018

  • Current management of oesophageal cancer
    N Rashid and others
    British Journal of Medical practicioners 2015 Volume 8, Issue 1, page 804

  • Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    F. Lordick and others
    Ann Oncol. 2016 27 Suppl 6: v50-v57

  • Oesophageal cancer
    E.C.Smith and others
    Nature Reviews Disease Primers Volume 3: 17048 (2018)

  • Oesophageal cancer
    J Lagergren and others
    The Lancet Vol 390, November 25th 2017

Last reviewed: 
10 Oct 2019

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