The CROSS trial: end of the debate on neoadjuvant therapy for esophageal cancer?

Department of Radiation Oncology, Box 3085, Duke University Medical Center, Durham, NC 27710, USA *Author for correspondence: Tel.: +1 919 668 7336; Fax: +1 919 668 7345; [email protected] The incidence of esophageal cancer has increased dramatically over the last few decades [1,2]. Despite substantial advances in surgery, chemotherapy and radiation therapy, mortality rates for this disease remain high [3]. The optimal treatment approach for patients with locally advanced disease remains controversial. Preoperative chemoradiotherapy is established as a standard of care in rectal cancer [4] and has shown promise in the treatment of other gastrointestinal malignancies. Preoperative chemo radiotherapy offers several potential biological and technical advantages when compared with either surgery alone, or with postoperative therapy delivery, including: