Moderately Hypofractionated Conformal Radiation Treatment of Thoracic Esophageal Carcinoma

  • Ma, Jin-Bo (Department of Radiation Oncology, Yantai Yuhuangding Hospital, School of Medicine, Qingdao University) ;
  • Wei, Lin (Center of Radiation Oncology, The Central Hospital of Tai An) ;
  • Chen, Er-Cheng (Department of Radiation Oncology, Yantai Yuhuangding Hospital, School of Medicine, Qingdao University) ;
  • Qin, Guang (Center of Radiation Oncology, The Central Hospital of Tai An) ;
  • Song, Yi-Peng (Department of Radiation Oncology, Yantai Yuhuangding Hospital, School of Medicine, Qingdao University) ;
  • Chen, Xiang-Ming (Center of Radiation Oncology, The Central Hospital of Tai An) ;
  • Hao, Chuan-Guo (Center of Radiation Oncology, The Central Hospital of Tai An)
  • Published : 2012.08.31


Aims: To prospectively assess the efficacy and safety of moderately hypofractionated conformal radiotherapy in patients with thoracic esophageal cancer. Methods and Materials: From Sept. 2002 to Oct, 2005, 150 eligible patients with T2-4N0-1M0 stage thoracic esophageal squamous cell cancers were enrolled to receive either conventional fractionated radiation (CFR) or moderately hypofractionated radiation (MHR) with a three-dimensional conformal radiation technique. Of the total, 74 received moderately hypofractionated radiation with total dose of 54-60Gy/18-20fractions for 3.5-4 weeks in the MHR arm, and 76 received conventional radiation with total dose of 60Gy/30 fractions for 6 weeks in the CFR arm. Concurrent chemotherapy comprised of paclitaxel and cisplatin. Safety was evaluated, and local control and overall survival rates were calculated. Results: Statistically significant differences between the CFR versus MHR arms were observed in local/regional failure rate (47.3% v 27.0%, P=0.034) and the percentage of patients with persistent local disease (26.3% v 10.8%, P=0.012). But 3 and 5-year overall survival rates (43.2%, 38.8% v 38.2%, 28.0%, respectively) were not different between the two arms (P=0.268). There were no significant differences in the incidences of grade 3 or higher acute toxicities (66.3% v 50.0%) and late complications rates (27.0% v 22.4%) between the MHR and CFR arms. Conclusions: Moderately hypofractionated, three-dimensional radiation treatment could improve the local control rate of esophageal cancer and potentially increase patients' survival.


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