Three-dimensional conformal radiation therapy for squamous cell carcinoma of the esophagus: A prospective phase I/II study
Received 21 March 2009; received in revised form 22 October 2009; accepted 22 October 2009. published online 18 November 2009.
Abstract
Purpose
A prospective phase I–II study was conducted to determine the tolerance and local control rate of three-dimensional conformal radiotherapy (3-DCRT) for esophageal squamous cell carcinoma (SCC).
Methods and materials
Thirty patients underwent 3-DCRT for thoracic esophageal SCC. PTV1 composed of a 1.2–1.5cm margin lateral around GTV and 3.0cm margin superior/inferior of GTV. PTV2 encompassed GTV with a margin of 0.5–0.7cm. The dose for PTV1 was 50Gy in 2Gy daily fractions; PTV2 received a boost of 16Gy in 2Gy daily fractions to a total dose of 66Gy.
Results
Median follow-up time was 18months. The most common acute toxicity was esophagitis in 63% of patients with RTOG grades 1–2, and in 3% with grade 3. RTOG grades 1–2 radiation pneumonitis developed in 27% of patients. One patient developed pulmonary fibrosis RTOG grade 2 and another patient experienced grade 3 pulmonary fibrosis. Two patients developed mild esophageal stricture requiring dilatation. Two-year overall survival, local disease progression-free rate, and distant metastasis-free rate were 69%, 36% and 56%, respectively.
Conclusions
Although 3-DCRT to 66Gy for esophageal SCC was well tolerated, the local control was disappointing. The result supports the use of chemoradiation as the standard care for esophageal SCC.
Department of Radiation Oncology, Fudan University Shanghai Cancer Hospital, Shanghai, PR China
Corresponding author. Address: Department of Radiation Oncology, Fudan University Shanghai Cancer Hospital, 270 Dong An Road, Shanghai 200032, PR China.
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