What Is Chemoradiotherapy, and When Is It Needed?

What is chemoradiotherapy?

Chemoradiotherapy is a treatment in which chemotherapy and radiotherapy are given together.

The cancers most commonly treated with chemoradiotherapy are:

• locally advanced esophageal (food pipe) cancer,
• stage 2 and 3 lung cancer,
• cervical (cervix) cancer,
• brain tumor (GBM) as postoperative adjuvant (protective) treatment,
• head and neck cancers.

In chemoradiotherapy:

• Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.
• Radiotherapy uses high-energy X-rays to treat cancer cells.

Giving these treatments together can provide a cure (complete healing) in some early-stage or locally advanced cancers.

Chemoradiotherapy given with the aim of a cure (complete healing) is called definitive (curative) treatment. Chemoradiotherapy is not given only with a definitive (complete healing) aim; sometimes it is given for neoadjuvant purposes (preparation for surgery, shrinking the tumor before surgery); in this case, radiation doses differ.

When is chemoradiotherapy needed?

The treatment plan depends on the size, stage and type of the person's cancer (adenocarcinoma or squamous cell cancer), as well as how good their health is.

• Chemoradiotherapy as your main treatment: If a person has, for example, locally advanced squamous cell esophageal cancer, they may receive chemoradiotherapy instead of surgery (definitive treatment). People are closely monitored after treatment (active surveillance).
• Chemoradiotherapy before surgery: If a person has adenocarcinoma or squamous cell cancer that has not spread to other parts of the body, they may receive chemoradiotherapy before surgery. This shrinks the cancer and makes it easier to remove, and is called neoadjuvant chemoradiotherapy.
• Chemoradiotherapy instead of surgery: Chemoradiotherapy may also be recommended if a person has other health problems indicating that they are not well enough for surgery, or if surgery is not possible because the cancer has grown into nearby tissues.