Late course accelerated hyperfractionated radiotherapy for clinical T1-2 esophageal carcinoma.
OBJECTIVE
This retrospective study was designed to analyze the results and the failure patterns of late course accelerated hyperfractionated radiotherapy for clinical T(1-2)N(0)M(0) esophageal carcinoma.


METHODS
From Aug. 1994 to Feb. 2001, 56 patients with clinical T(1-2) esophageal carcinoma received late course accelerated hyperfractionated radiotherapy in Cancer Hospital, Fudan University. All patients had been histologically proven to have squamous cell carcinoma (SCC) and were diagnosed to be T(1-2)N(0)M(0) by CT scan. All patients were treated with conventional fractionation (CF) irradiation during the first two-thirds course of the treatment to a dose of about 41.4Gy/23fx/4 to 5 weeks, Which was then followed by accelerated hyperfractionation irradiation using reduced fields, twice daily at 1.5Gy per fraction, to a dose about 27Gy/18 fx. Thus the total dose was 67-70Gy/40-43fx/40-49 d.


RESULTS
The 1-, 3- and 5-year overall survival was 90.9 %, 54.6 %, 47.8 % respectively. The 1-, 3- and 5-year local control rate was 90.9 %, 84.5 % and 84.5 %, respectively. Twenty-five percent (14/56) patients had distant metastasis and/or lymph nodes metastasis alone. Eight point nine percent (5/56) patients had local disease alone. Another 3.6 % (2/56) patients had regional relapse and distant metastasis.


CONCLUSIONS
Late course accelerated hyperfractionated radiotherapy is effective on clinical T(1-2) esophageal carcinoma. The main failure pattern is distant metastasis.
Zhao
Kuai-Le
KL
Department of Radiation Oncology, Cancer Hospital, Fudan University, Shanghai 200032, China. kuaile_z@sina.com
Wang
Yang
Y
Shi
Xue-Hui
XH
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000556:secondary; D019583:Dose Fractionation, Radiation; D004938:Esophageal Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis