Involved field irradiation for the treatment of esophageal cancer: Is it better than elective nodal irradiation?

Esophageal cancer (EC) is an extremely aggressive and lethal malignancy with an increasing incidence worldwide. Currently, the combination of radiotherapy and concurrent chemotherapy is performed for nonsurgical EC. However, there is no clear consensus on the accurate definition of the clinical target volume. Still, elective nodal irradiation (ENI) is the conventional remedy adopted for EC patients, while severe radiotherapy-related toxicities would occur in at least half of patients. Involved field irradiation (IFI) is a selective way to decrease the irradiation volume and thereby to decline toxicities. This review centers on the modality of IFI and compares the treatment efficacy between IFI and ENI.