Procedure
Radiation therapy focuses high-energy X-rays on the tumor inside the body to specifically kill it. Radiotherapy is either an equivalent alternative to surgery or is used when surgery is not possible. It can also be carried out in combination with chemotherapy and subsequent surgery (known as trimodal therapy).
Radiotherapy can also be used if the cancer has already spread: radiotherapy can then prevent or alleviate symptoms caused by metastases, e.g. in the brain or bones(palliative radiotherapy).
Radiation therapy is performed as an outpatient treatment, is non-invasive (i.e. does not require anesthesia) and can thus be easily integrated into everyday private and professional life. Depending on the extent of the tumor, radiotherapy can be carried out as radiosurgery in one or a few treatment sessions for small tumor foci, or as fractionated treatment over several weeks for larger tumors. Radiation therapy is often combined with chemotherapy or immunotherapy to improve efficacy. Close and personal support is a matter of course for us.
The Department of Radiation Oncology at the USZ uses only the most modern techniques for precise and low-side-effect radiation treatment of esophageal cancer. You will be looked after by proven experts in the treatment of esophageal cancer.
For many patients, we are already offering tomorrow’s treatment today: in clinical trials, we are continuously working on improving the treatment of oesophageal cancer to make it even more effective and tolerable. To the overview of currently open studies.
In the following, we will describe radiotherapy for the different types and stages of esophageal cancer.
Locally advanced esophageal tumor in the operable stage
In the case of locally advanced esophageal tumors, surgical removal of the tumor is often the treatment of first choice in fit patients. In the case of larger tumors and if there are already metastases in the lymph nodes, this is supplemented by upstream radiotherapy. This reduces the risk of recurrence in the future, improves the overall prognosis and simplifies the removal of the tumor.
Depending on the stage of the tumor and the patient’s general condition, chemotherapy is also given alongside radiotherapy in order to eliminate any cancer cells that may have spread and to make the cells more sensitive to radiation. The combination of surgery, radiotherapy and chemotherapy as so-called „trimodal therapy“ then offers the greatest chances of recovery.
Due to the often extensive treatment area, the radiation is divided into many small „portions“: the therapy is fractionated over 23 treatment sessions every working day over a period of around 5 weeks. Spreading the radiation treatment over several weeks improves the tolerability of the treatment, which is mainly carried out on an outpatient basis and can be easily integrated into the patient’s private and professional life.
It goes without saying that patients receive regular medical care during this time in order to provide the best possible support for illness-related nutritional problems and complaints.
In these cases, examinations are carried out again 6 weeks after the end of radiotherapy to assess the response. The operation is then planned at the esophageal center.
Radiotherapy of esophageal cancer is a clinical focus of our clinic and is represented clinically and scientifically by Dr. H. Garcia Schüler. We pass on our knowledge in international courses and congresses. We are also active in international committees for quality assurance in studies. State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety.
At the same time, we work closely with our colleagues in surgery and medical oncology in order to guarantee treatment „from a single source“. This is already ensured by the interdisciplinary consultation hours of the Esophageal Center, which take place before the start of treatment, where you will be advised in a consultation with doctors from visceral surgery, medical oncology and radio-oncology at the same time
In clinical trials, we are continuously trying to improve the treatment of esophageal cancer in order to make it even more effective and tolerable. To the overview of currently open studies.
Locally advanced esophageal tumor, inoperable
A combination of radiation and chemotherapy can be an equivalent treatment alternative to surgery for older patients, patients with reduced lung function or with underlying diseases, e.g. heart disease, that make anesthesia risky, as well as for tumors that make surgery difficult due to their location.
In these cases, the radiation is divided into many small „portions“: the therapy is fractionated over approx. 33 treatment sessions per working day over a period of about 7 weeks. Spreading the radiation treatment over several weeks improves the tolerability of the treatment, which is mainly carried out on an outpatient basis and can be integrated into the patient’s private and professional life.
It goes without saying that patients receive regular medical care during this time in order to provide the best possible support for illness-related nutritional problems and complaints.
At the same time, we work closely with our colleagues in surgery and medical oncology in order to guarantee treatment „from a single source“. This is already made clear by the therapy sessions that take place before the therapy begins. This is already ensured by the interdisciplinary consultation hours of the Esophageal Center, which take place before the start of treatment, where you will be advised in a consultation with doctors from visceral surgery, medical oncology and radio-oncology at the same time
In clinical trials, we are continuously trying to improve the treatment of esophageal cancer in order to make it even more effective and tolerable. To the overview of currently open studies.
Metastases of esophageal cancer, e.g. in the brain or bones
Esophageal cancer is an aggressive type of cancer that often forms metastases during the course of the disease: this is called metastasis. Common sites of metastasis are the lung, adrenal gland, bones, liver or brain. Radiotherapy is a highly effective method with few side effects to prevent or treat symptoms caused by metastases. This is usually done in combination with chemotherapy, immunotherapy or other targeted therapy. The smaller the metastases are and the earlier they are irradiated, the better the results. Today, metastases in the body can be treated in a focused manner in just a few effective radiation sessions.
For tumor foci in the abdominal area, e.g. liver or upper abdomen, we carry out body stereotactic radiotherapy (SBRT) on our MRI hybrid accelerator. State-of-the-art radiation technology is combined with MRI images. The radiation is thus carried out under MRI monitoring of the tumor, so that the highest precision is combined with the best imaging. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.
Today, brain metastases are treated at our center in most patients by means of a single high-dose radiation treatment: this is called radiosurgery.
Metastases at other locations in the body can now also be treated in a focused manner in just a few effective radiation sessions.
Metastatic esophageal cancer is a clinical and scientific focus of our clinic. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions.
State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety. At the same time, we work closely with our colleagues in medical oncology to guarantee treatment „from a single source“. We also consult with our colleagues in palliative medicine at an early stage.
In clinical trials, we are continuously trying to improve the treatment of esophageal cancer in order to make it even more effective and tolerable. To the overview of currently open studies.
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