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Elective nodal irradiation ( ENI ) might improve overall survival in patients with inoperable esophageal cancer. We conducted a retrospective analysis to assess the long‐term survival and toxicity of esophageal cancer patients treated with  ENI  versus conventional‐field irradiation ( CFI ). All data in the present study were based on our institutional experience from 2000 to 2005 of patients with inoperable esophageal cancer treated with  ENI  or  CFI  plus two concurrent cycles of paclitaxel/cisplatin. Based on the inclusion and exclusion criteria, 89 patients were included in the analysis. Of these patients, 51 were treated with  ENI , whereas 38 were treated with  CFI . For the per‐protocol population, the patients in the  ENI  group significantly improved in terms of their 10‐year disease‐specific overall survival (43.1%  vs  10.5%,  P  = 0.019), 10‐year disease‐free survival (36.7%  vs  10.2%,  P  = 0.040) and 10‐year local recurrence‐free survival (47.2%  vs  17.2%,  P  = 0.018) compared with the  CFI  group. Aside from radiation esophagitis, the incidence of grade 3 or greater acute toxicities did not differ between the two groups. Multivariate analysis showed that radiation field, tumor length and clinical stage were independent prognostic factors associated with  OS . Concurrent chemoradiotherapy with  ENI  improves both disease‐specific overall survival and loco‐regional control in patients with inoperable esophageal cancer receiving per‐protocol treatment. The regimen has a manageable tolerability profile.

Long‐term outcome of concurrent chemoradiotherapy with elective nodal irradiation for inoperable esophageal cancer