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[Review of medical or combined treatment of local or locally advanced oesophageal cancer].

More than 800 oesophageal tumours are diagnosed each year in Hungary. The disease is characterized by high mortality. The curative treatment traditionally surgical, although the study results of recent decades pointed out that patient outcome can be improved with the proper application of radio- and chemotherapy. The diverse study designs, the low number of recruited patients and the sometimes conflicting results make the determination of optimal treatment difficult. The aim of this work is to facilitate the choice of treatment modality with the best outcome, especially with the view of medical oncologists. The treatment remains surgery for very early tumours (up to pT1b) and palliative therapy for tumours with metastasis. In other cases additional therapy, such as chemotherapy, radiotherapy, or their combinations, and targeted therapies, may result in improved survival. There are data mostly for neoadjuvant therapy because patients after surgery are rarely candidates for adjuvant therapy. Neoadjuvant chemotherapy may improve survival over surgery alone, but this improvement is more pronounced and supported by more evidence for neoadjuvant chemoradiotherapy (CRT). Certain results suggest that in selected cases after neoadjuvant CRT omission of surgery might not compromise survival, but the routine omission of surgery is not advised. However, the agent given concomitantly to radiotherapy may have importance. Besides cisplatin and fluorouracil other platinum derivatives (carboplatin, oxaliplatin) and taxanes (docetaxel, paclitaxel) can be used without compromising survival but with more favourable toxicity profile.