Is radiation therapy needed in the treatment of gastroesophageal junction adenocarcinoma?

There have been very few treatment-related studies specifically addressing adenocarcinomas of the gastroesophageal junction (GEJ). Studies addressing esophageal cancer have a larger percentage of patients with GEJ adenocarcinomas than do the primary gastric trials. Studies of surgery alone have shown high local failure rates for both esophageal and gastric cancers, and for both anatomic sites the addition of radiation therapy has been shown to decrease the local failure rate and improve survival. Chemotherapy as an adjuvant to surgery has also been shown to be of value in both anatomic sites. Combining all three treatment modalities, surgery, radiation therapy, and chemotherapy, is likely to produce the best overall outcomes for patients with this disease, which is rapidly increasing in incidence.