In general, the most problematic issue from the past was that swallowing disorders and getting a stiff neck and all these things were impairing quality of life enormously. And on the other side, at risk, we saw that IMRT and the new strategies for radiotherapy really could diminish this late toxicity, swallowing disorders, enormously. So we are on a good way, in a certain way, to decrease late toxicity without paying a bigger price in the direction of less survival...
In general, the most problematic issue from the past was that swallowing disorders and getting a stiff neck and all these things were impairing quality of life enormously. And on the other side, at risk, we saw that IMRT and the new strategies for radiotherapy really could diminish this late toxicity, swallowing disorders, enormously. So we are on a good way, in a certain way, to decrease late toxicity without paying a bigger price in the direction of less survival. So things are moving on and the combination therapy is fine. And I think the idea to say, keep one modality, and if possible, one modality, that’s enough, don’t spread modalities. So, at the end, a three-modality treatment is principally bad. I don’t think so. You have to combine it. You have to be clever, you have to reduce the dose of the single modality. Maybe we can one day, if we start up now, gain experience in perioperative immunotherapy, we can start learning how to reduce our borders in resection so that surgery can be a little bit, let’s say, adapted to the outcome of the biology of the disease we learn by neoadjuvant treatments and so on. So, there are a lot of things to do, and it’s not black and white. It’s a very complex thing, and locations are different.
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