Abstract：Objective This non-randomized prospective phase Ⅱ study was designed to investigate the safety and feasibility of adjuvant intensity-modulated radiotherapy or three-dimensional conformal radiotherapy (IMRT/3DCRT) after radical surgery for pT2-3N0M0 thoracic esophageal squamous cell carcinoma (TESCC). Methods Ninety-six patients were enrolled from 2004 to 2011. The prescribed dose was 50-60 Gy in 1.8-2.0 Gy per fraction (5 days per week) to 95% of the planning target volume (PTV), encompassing the tumor bed and lymphatic drainage regions at high risk according to the primary tumor location. The survival rate was calculated by Kaplan-Meier method. Results The average PTV coverage of the prescribed dose was (94.9±0.7)%. The median bilateral lung V20 was 23.6%(9.8%-29.7%);the median stomach V50 was 9.4%(0-39.2%);the median heart V30 and V40 were 33.3%(0-67.6%) and 17.1%(0-42.0%), respectively;the median maximal dose to the spinal cord was 40.4 Gy (32.9-45.5 Gy). The number of samples at 5 years was 35. The 5-year overall survival rate and disease-free survival rate were 74% and 71%, respectively. Grade 3 and 4-5 toxicities occurred in 25(26%) and 0 patients, respectively. Recurrence and metastasis were seen in 22(23%) patients, of whom 18(19%) and 11(12%) had locoregional recurrence and distant metastasis, respectively. Conclusions Adjuvant IMRT/3DCRT for pT2-3N0M0 TESCC is tolerable and clinically feasible, and provides excellent local control and favorable survival. Further confirmation in a randomized trial is merited.
Yang Jinsong,Liu Xiao,Xiao Zefen et al. Prospective phase Ⅱ study of three-dimensional radiotherapy after radical surgery for pT2-3N0M0 esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2015, 24(1): 29-32.
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