Results of radiation therapy for superficial esophageal cancer using the standard radiotherapy method recommended by the Japanese Society of Therapeutic Radiology and Oncology (JASTRO) Study Group.
BACKGROUND
Superficial esophageal cancer (SEC) is defined as esophageal cancer limited to the submucosal layers, including mucosal cancer and submucosal cancer, and is squamous cell carcinoma in most patients. In 2000, the Japanese Society of Therapeutic Radiology and Oncology (JASTRO) Study Group for SEC published a consensus guideline of standard radiotherapy methods. In this study, the interim treatment outcomes of SEC patients, who had received radiation therapy following the standard radiotherapy methods, were investigated.


METHODS
From 2000 to 2003, a total of 141 SEC patients were treated in 24 institutions in Japan.


RESULTS
The 1-, 2- and 3-year survival rates were 95%, 90% and 90%, respectively, for patients with mucosal cancer and 90%, 81% and 70%, respectively, for patients with submucosal cancer. The overall survival was better in patients who had undergone chemotherapy than in patients who had received radiation therapy alone, though the difference was not statistically significant. The clinical target volume (CTV) did not influence overall survival and intracavitary irradiation did not influence the local control rate in either patients with mucosal or submucosal cancer. Radiation-induced esophageal ulcer was not observed in this series.


CONCLUSIONS
The standard radiotherapy methods are safe and effective for treating SEC. However, the usefulness of chemotherapy and intracavitary irradiation and the optimal setting of the CTV should be clarified by future randomized trials.
Nemoto
Kenji
K
Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aobaku, Sendai 980-8574, Japan. knemoto@rad.med.tohoku.ac.jp
Yamada
Shogo
S
Nishio
Masamichi
M
Aoki
Masahiko
M
Nakamura
Ryuji
R
Matsumoto
Yasuo
Y
Sasamoto
Ryuta
R
Saitoh
Yoshihiro
Y
Takayama
Makoto
M
Mitsuhashi
Norio
N
Gomi
Kohtaro
K
Kanesaka
Naoto
N
Kobayashi
Masao
M
Ohnishi
Hiroshi
H
Sasaki
Shigeru
S
Tamamura
Hiroyasu
H
Mitsumori
Michihide
M
Nishimura
Yasumasa
Y
Tsujino
Kayoko
K
Takemoto
Mitsuhiro
M
Uchida
Nobue
N
Yamamoto
Michinori
M
Shioyama
Yoshiyuki
Y
Hirakawa
Kohichi
K
Ono
Seiji
S
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods / Q000592:standards; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods / Q000592:standards; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome
D002945:Cisplatin; D005472:Fluorouracil