The role of radiation therapy in upper gastrointestinal cancers.

Upper gastrointestinal cancers are common and account for a high proportion of cases of cancer-related morbidity and mortality. Combined-modality therapy with surgery, chemotherapy, and radiation therapy is standard treatment for esophageal and gastroesophageal junction cancers. For gastric cancer, the need to include radiation therapy appears to depend on the quality of the surgery performed. Radiation therapy plays an uncertain role in the surgical management of pancreatic cancer, and the results of ongoing clinical trials are awaited. Retrospective studies support the inclusion of radiotherapy in the surgical management of biliary tract cancers. The development of more effective systemic therapy for upper gastrointestinal cancers may ultimately lead to a greater survival benefit due to the potential for improved local tumor control achieved with radiotherapy.