This review article discussed the emerging role of PBT for esophageal cancer, including rationale, treatment planning, early dosimetric and clinical comparisons of PBT with photon-based techniques, ongoing prospective trials, and potential areas of opportunity for the incorporation of PBT with the goal of improving outcomes for patients with esophageal cancer.

Clinical data support the feasibility, efficacy, and favorable AE profile for curative intent proton-based CRT for esophageal cancer, in addition, suggesting PBT may be associated with improved survival potentially attributable to toxicity reduction, including cardiopulmonary sparing or through a reduction in severe treatment-related lymphopenia which has been associated with disease recurrence and OS.