Abstract：Objective To evaluate the efficacy and side effects of extensive regional field radiotherapy concurrent with chemotherapy for locally advanced esophageal cancer. Methods Of the 101 patients with locally advanced esophageal cancer patients, 44 patients were treated by involved field radiotherapy alone, 29 patients treated by involved field radiotherapy combined with chemotherapy, and 28 patients received extensive regional field radiotherapy combined with chemotherapy, the total dose of radiotherapy was 60 Gy．The clinical target volume (CTV) of involved field included the gross tumor volume (GTV) plus a 0.8 cm lateral margin, the tumor plus a nominal 3－5 cm cephalad and caudal margin. Extensive regional field radiotherapy was delivered in two steps:the CTV included the CTV of the involved field plus elective nodal region in the first step;in the second step, the CTV definition was same with the CTV of the involved field. Synchronous chemotherapy regimens included TP and NP. Results 90.1% patients completed planned radiotherapy, all patients in the concurrent chemotherapy groups completed at least one cycle of chemotherapy. The follow-up rate was 99%. Twenty-four and 42 patients completed followed-up more than 24 months in the radiotherapy alone and concurrent chemoradiotherapy group, respectively. The median survival time of the involved field radiotherapy group, involved field chemoradiotherapy group and extensive regional field chemoradiotherapy group was 13, 21 and 19 months, respectively;the 2-year overall survival (OS) rate was 15%, 48% and 46%, respectively for the three groups. The 2-year OS rate was improved significantly in the chemoradiotherapy group (χ2=6.83,P=0.033). Compared with radiotherapy alone group, the incidence of grade three or four bone marrowsuppression was higher in the concurrent chemoradiotherapy group (53%∶0%,χ2=32.94,P=0.000), DOI:10.3760/cma.j.issn.1004-4221.2012.06.011 基金项目:浙江省重大科技专项重点社会发展项目(2011C13039-2);恩泽医疗集团基金(2012) 作者单位:317000 台州,温州医学院附属台州医院放疗科(周超、杨海华、胡炜、柯文婷、王碧云),胸外科(孔敏、朱成楚)the remaining adverse events(acute radiation pneumonitis, acute radiation esophagitis, esophageal fibrosis, late radiation lung injury) had no significant intergroup differences (χ2=5.56,6.70,2.39,0.42,P=0.235,0.349,0.881,0.981). Conclusions Compared with radiotherapy alone, concurrent chemoradiotherapy can improve the survival rate for locally advanced esophageal cancer. The side effects of the extensive regional field radiotherapy combined with chemotherapy is well tolerated. But the efficacy of the extensive regional field radiotherapy combined with chemotherapy needs further research.
ZHOU Chao*,YANG Hai-hua,HU Wei et al. Clinical research of extensive regional field radiotherapy concurrent with chemotherapy for locally advanced esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2012, 21(6): 522-525.
2012, Vol. 21 
