Abstract：Objective To investigate the value of prophylactic irradiation to the lymphatic drainage area in radical three-dimensional conformal radiotherapy (3DCRT) and to evaluate the efficacy and adverse effects of 3DCRT with different clinical target volumes. Methods A retrospective analysis was performed on the records of 219 esophageal cancer patients without distant metastasis who received 3DCRT from January 2005 to December 2010. One hundred and five patients received involved-field irradiation (IFI) with a total dose of 54—66 Gy;114 patients received elective nodal irradiation (ENI) with a total dose of 46—52 Gy;the prescribed dose to the primary lesion was 56—70 Gy. The Kaplan-Meier method was used to calculate local control (LC) and overall survival (OS) rates, and the log-rank test was used for univariate prognostic analysis. Results The 1-, 3-, and 5-year sample sizes were 219,172 and 67, respectively. The 1-, 3-, and 5-year LC rates for IFI group were 63.0%, 39.1%, and 27.2%, respectively, versus 70.5%, 53.3%, and 51.7% for ENI group (χ2=6.22, P=0.013);the 1-, 3-, and 5-year OS rates for IFI group were 67.6%, 24.9%, and 15.0%, respectively, versus 73.7%, 45.1%, and 26.0% for ENI group (χ2=5.04, P=0.025). The univariate stratified analysis showed that the LC and OS rates were significantly higher in the ENI group than in the IFI group for patients with middle-or lower-thoracic primary lesion or N0 disease (P=0.007,0.015;P=0.054,0.013). Conclusions For esophageal cancer patients with middle-or lower-thoracic primary lesion or without lymph node metastasis, prophylactic irradiation to the lymphatic drainage area can increase LC and OS rates.
Zhu Shuchai,Xu Jinrui,Liu Zhikun et al. A preliminary study of three-dimensional conformal radiotherapy with different clinical target volumes for esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2014, 23(2): 127-111.
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2014, Vol. 23 
