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Long-term clinical outcome of intensity-modulated radiation therapy for locally advanced esophageal squamous cell carcinoma

Abstract

Purpose

This study evaluated the effectiveness and safety of intensity-modulated radiation therapy (IMRT) for locally advanced esophageal squamous cell carcinoma (ESCC).

Methods

Between August 2009 and December 2011, 112 patients with pathologically confirmed ESCC treated with IMRT at Jiangsu Province People’s Hospital and Nantong Tumor Hospital were included in a retrospective analysis. Patients received either IMRT alone (group A) or concurrent chemoradiotherapy (CRT) (group B). A radiation dose of 60-66 Gy administered in 30-33 fractions was delivered to the tumor. The patients in group B simultaneously received 2 cycles of cisplatin-based doublets with either 5-fluorouracil or taxotere. The Kaplan-Meier method was used to compute the survival time. Early and late toxicities were scored according to CTCAE v.3.0.

Results

The response rate of group B (91.07%) was not significantly greater than that of group A (89.29%) (χ2 = 0.10, p = 0.75). The 1- and 3-year survival rates of group B (87.5% and 57.14%, respectively) were greater than those of group A (69.64% and 37.50%, respectively). The difference in overall survival was statistically significant between groups A and B (χ2 = 5.30, p = 0.02; χ2 = 4.33, p = 0.04). Hematological toxicity, gastrointestinal toxicity, and treatment-related esophagitis were significantly higher in group B than group A (16.07% vs. 33.93%, p = 0.04; 10.71% vs. 26.79%, p = 0.03; 19.64% vs. 44.64%, p = 0.01). However, intergroup differences in terms of late toxicity were not significant.

Conclusions

IMRT was a practical and feasible technique to treat ESCC. Concurrent CRT could increase local tumor control and long-term survival. The CRT regimen was associated with a higher incidence of acute gastrointestinal and hematological toxicity.

Tumori 2015; 101(2): 168 - 173

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000234

Authors

Xiaolin Ge, Xi Yang, Xiaohu Lu, Wei Wen, Fuxi Zhen, Hongxun Ye, Hongcheng Zhu, Yuandong Cao, Sheng Zhang, Hongyan Cheng, Jianxin Ma, Baixia Yang, Shengbin Dai, Qing Guo, Jing Cai, Xinchen Sun

Article History

Disclosures

Financial support: The study was supported by the Natural Science Foundation of China (Nos. 81272504 and 81472809), the Innovation Team (No. LJ201123-EH11), Jiangsu Provincial Science and Technology Projects BK2011854 (DA11), and the Six Major Talent Peak Project of Jiangsu Province. The priority academic program development of Jiangsu Higher Education Institution (JX10231801), grants from the Key Academic Discipline of Jiangsu Province “Medical Aspects of Specific Environments,” and “333” Project of Jiangsu Province BRA2012210 (RS12) funded our study.
Conflict of interest: The authors declare that no known conflicts of interest are associated with this publication.

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Authors

Affiliations

  • Department of Radiotherapy, The First Affiliated Hospital of Nanjing Medical University, Nanjing - China
  • Department of Cardiothoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing - China
  • Department of Radiotherapy, Taixing People’s Hospital, Taixing - China
  • Department of Synthetic Internal Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing - China
  • Department of Radiotherapy, Second People’s Hospital of Lianyungang, Lianyungang Hospital Affiliated to Bengbu Medical College, Lianyungang - China
  • Department of Radiotherapy, The Affiliated Tumor Hospital of Nantong University, Nantong - China
  • Department of Radiotherapy, Taizhou People’s Hospital, Taizhou - China
  • Xiaolin Ge, Xi Yang and Xiaohu Lu contributed equally to the study

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