Open AccessEfficacy of intensity‐modulated radiotherapy for resected thoracic esophageal squamous cell carcinoma
Author(s) -
Zhang Wencheng,
Liu Xiao,
Xiao Zefen,
Wang Lvhua,
Zhang Hongxing,
Chen Dongfu,
Zhou Zongmei,
Feng Qinfu,
Hui Zhouguang,
Liang Jun,
Yin Weibo,
He Jie
Publication year - 2015
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.12228
Subject(s) - medicine , radiation therapy , univariate analysis , esophageal cancer , esophagitis , radiology , lymph , pneumonitis , stage (stratigraphy) , survival rate , carcinoma , cancer , multivariate analysis , lung , pathology , disease , paleontology , reflux , biology
Background Little is known about the clinical use of intensity‐modulated radiotherapy ( IMRT ) in postoperative radiotherapy ( PORT ) of esophageal cancer; therefore, we retrospectively investigated the clinical value of postoperative IMRT among resected thoracic esophageal squamous cell carcinoma ( TESCC ) patients. Methods We enrolled a total of 228 patients with resected TESCC who underwent IMRT between J anuary 2004 and J une 2009 in the study. PORT was applied via IMRT with a median total dose of 60 Gy. The K aplan– M eier method was used to calculate survival rates, and a log‐rank test was used for univariate analysis. The C ox proportional model was used for multivariate analysis. Results The one, three, and five‐year overall survival rates of all patients were 89.9%, 56.7%, and 45.1%, respectively. Univariate analysis showed that significant prognostic factors included U nion for I nternational C ancer C ontrol 2002 stage, lymphatic metastasis, number of metastatic lymph nodes, the degree of metastatic lymph nodes, the degree of differentiation, and vascular tumor thrombus ( P < 0.05). Treatment failure occurred in 98 (45.2%) patients because of recurrence or metastases. Early reactions were observed at rates of 18.0% for radiation esophagitis and 5.7% for radiation pneumonitis more than grade 2. Late side effects included anastomotic stenosis (1.3%) and gastrointestinal bleeding (3.1%). Conclusions The postoperative prophylactic IMRT of TESCC provided a favorable local control rate and acceptable toxicity.