Abstract:Objective To compare the efficacy of elective nodal prophylactic irradiation (ENI) and involved-field irradiation (IFI) in radical radiotherapy for early-stage esophageal cancer and to determine the appropriate irradiation range for early-stage esophageal cancer. Methods The clinical data of 121 patients with early-stage esophageal cancer receiving radical radiotherapy in our hospital from January 2006 to December 2011 were collected and respectively analyzed. Sixty-one patients received ENI, and the other 60 patients received IFI. The Kaplan-Meier method was used to calculate local control (LC) and overall survival (OS) rates;the log-rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The 1-, 3-, and 5-year LC rates in ENI group and IFI group were 81.1%, 60.1%, and 57.5% vs. 64.5%, 43.9%, and 27.2%, respectively (P=0.003). The 1-, 3-, and 5-year OS rates in ENI group and IFI group were 86.9%, 56.8%, and 34.8% vs. 86.7%, 34.3%, and 19.1%, respectively (P=0.019). The 1-, 3-, and 5-year overall failure rates in ENI group and IFI group were 22.3%, 53.8%, and 63.2% vs. 43.3%, 65.8%, and 78.8%, respectively (P=0.023). Multivariate analysis showed that irradiation range was the influencing factor for LC and OS. Conclusions As for the radical radiotherapy for early-stage esophageal cancer, ENI can significantly increase LC and reduce locoregional failure, and therefore improve long-term OS.
Zhu Shuchai,Dong Hui,Liu Zhikun et al. A comparative study of different irradiation ranges in radical radiotherapy for early-stage esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2015, 24(6): 615-618.