Esophagus


 * Epidemiology: || Esophageal carcinoma is the 7th leading cause in cancer deaths worldwide, 95% is squamous cell. The greatest incidence occurs in North China, Russia, and Caspian Sea with high risk cluster appearing in South Africa, northern France, Hong Kong and Brazil.1, 2

3 In the United States, esophageal carcinoma accounts for 1% of all malignancies and 6% of all gastrointestinal carcinomas. The histological incidence between adenocarcinoma and squamous cell are approximately equal statistically.1 It is estimated by the American Cancer Society in 2010 there would have been 16,640 new cases and 14,500 deaths from esophageal cancer. 2 In the United States: Explain || (doses, borders, boosts, planning techniques, etc.) || 1 Halperin E, Perez CA, Brady LW. //Perez and Brady's Principles and Practice of Radiation Oncology//. 5th edition. Philadelphia: Lippincott, Williams & Wilkins. 2008 2 American Cancer Society. //Cancer facts & figures 2010//. Atlanta: American Cancer Society; 2010 3 Medscape Reference. //Esophageal cancer//. Available at: [] Accessed on June 4, 2011
 * African-American has a higher incidence than white-American.
 * Male to Female ratio is: 3-4:1
 * Occurs most commonly in the age range: 60-70
 * Age 65 and >: 20 times more common 3 ||
 * Etiology: || Esophageal cancer has been linked to:
 * Barrett’s esophagus (Most common predisposing factor for adenocarcinoma of esophagus)
 * Gastroesophageal reflux disease (GERD)
 * Human papilloma virus (HPV)
 * Tylosis Palmaris et plantaris
 * Plummer-Vinson syndrome (iron deficient anemia and low ribroflavin level)
 * Alkaline soil
 * Arid climate
 * Exposure to noxious or toxic stimuli to the mucosa
 * Ingestion of nitrosamine, nitrosamides and n-nitroso (found in nitrate rich foods such as:
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Pickled vegetables
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Fish
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Cured meat
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Alcohol
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Smoking
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Dietary intake of
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Corn
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Wheat
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Millet
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Vitamin and nutritional deficiencies
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Decreased dietary intake of
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Fruit
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Vegetables
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Animal products
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Vitamin
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Riboflavin
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Microelements (Vitamin factors that may contribute high incidence in China)
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Genetic factors for squalors cell of esophagus
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Mutation of p53
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Multiple allelic losses in 3p and 9q with amplification of cyclin D1 and epidermal growth factor receptor (EGFR)
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Genetic factors for adenocarcinoma of esophagus
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Over expression of p53
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Multiple allelic losses in 17p, 5q and 13q
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Amplification and over expression of EGFR and Human epidermal growth factor receptor (HER-2) 1
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Genetic and molecular factors
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Alterations in gene p16
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Cell cycle abnormalities
 * <span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 12pt;">Aneuploidy 3 ||
 * Signs & Symptoms: || Detection and Diagnosis ||
 * Diagnostic Procedures: || Detection and Diagnosis ||
 * Histology: ||  ||
 * Lymph Node Drainage: ||  ||
 * Metastatic Spread: ||  ||
 * Grading: ||  ||
 * Staging: || Name the system
 * Radiation Side Effects: || Side effects, Dse and time frame ||
 * Prognosis: ||  ||
 * Treatments: || Surgery, Chemotherapy, and Radiation Therapy
 * TD5/5: || of organs of interest within treatement field ||