Clinical results of proton beam therapy for cancer of the esophagus.
OBJECTIVE
To present the results of proton beam therapy for patients with esophageal cancer.


METHODS
This study reviewed 46 patients with esophageal cancer who were treated between 1985 and 1998 using proton beams with or without X-rays. All patients had locoregionally confined disease; all but one had squamous cell carcinoma. Of the 46 patients, 40 received combinations of X-rays (median, 48 Gy) and protons (median, 31.7 Gy) as a boost. The median total dose of combined X-ray and proton radiation for the 40 patients was 76.0 Gy (range, 69.1-87.4 Gy). The remaining 6 patients received only proton beam therapy (median, 82.0 Gy; range, 75-89.5 Gy).


RESULTS
The 5-year actuarial survival rate for the 46 patients, patients with T1 (n = 23), and those with T2-T4 (n = 23) was 34%, 55%, and 13%, respectively. The 5-year disease-specific survival rate for the 46 patients, those with T1, and those with T2-T4 was 67%, 95%, and 33%, respectively. The 5-year local control rate for patients with T1 and T2-T4 lesions was 83% and 29%, respectively. The site of the first relapse was locoregional for 16 patients and distant organs for 2 patients.


CONCLUSIONS
The results suggest that proton beam therapy is an effective treatment for patients with locally confined esophageal cancer. Additional studies are required to determine the optimal total dose, fractionation schedule, and best combinations of protons and conventional X-rays with or without chemotherapy.
Sugahara
Shinji
S
Department of Radiation Oncology, Institute of Clinical Medicine , University of Tsukuba, Tennodai, Tsukuba, Ibaraki, Japan. ssuga@md.tsukuba.ac.jp
Tokuuye
Koichi
K
Okumura
Toshiyuki
T
Nakahara
Akira
A
Saida
Yukihisa
Y
Kagei
Kenji
K
Ohara
Kiyoshi
K
Hata
Masaharu
M
Igaki
Hiroshi
H
Akine
Yasuyuki
Y
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D061766:Proton Therapy; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D015996:Survival Rate; D011522:Protons
D011522:Protons