title: Moderately hypofractionated conformal radiation treatment of thoracic esophageal carcinoma.
abstract: OBJECTIVE
  To prospectively assess the efficacy and safety of moderately hypofractionated conformal radiotherapy in patients with thoracic esophageal cancer.
  
  
  METHODS
  From Sept. 2002 to Oct. 2005, 150 eligible patients with T2-4N0-1M0 stage thoracic esophageal squamous cell cancers were enrolled to receive either conventional fractionated radiation (CFR) or moderately hypofractionated radiation (MHR) with a three- dimensional conformal radiation technique. Of the total, 74 received moderately hypofractionated radiation with total dose of 54-60 Gy/18-20 fractions for 3.5-4 weeks in the MHR arm, and 76 received conventional radiation with total dose of 60 Gy/30 fractions for 6 weeks in the CFR arm. Concurrent chemotherapy comprised of paclitaxel and cisplatin. Safety was evaluated, and local control and overall survival rates were calculated.
  
  
  RESULTS
  Statistically significant differences between the CFR versus MHR arms were observed in local/regional failure rate (47.3% v 27.0%, P=0.034) and the percentage of patients with persistent local disease (26.3% v 10.8%, P=0.012). But 3 and 5-year overall survival rates (43.2%, 38.8% v 38.2%, 28.0%, respectively) were not different between the two arms (P=0.268). There were no significant differences in the incidences of grade 3 or higher acute toxicities (66.3% v 50.0%) and late complications rates (27.0% v 22.4%) between the MHR and CFR arms.
  
  
  CONCLUSIONS
  Moderately hypofractionated, three-dimensional radiation treatment could improve the local control rate of esophageal cancer and potentially increase patient survival.
authors.affiliation: Department of Radiation Oncology, Yantai Yuhuangding Hospital, School of Medicine, Qingdao University, Yantai, China.
authors.forename: Jin-Bo
authors.initials: JB
authors.lastname: Ma
authors.forename: Lin
authors.initials: L
authors.lastname: Wei
authors.forename: Er-Cheng
authors.initials: EC
authors.lastname: Chen
authors.forename: Guang
authors.initials: G
authors.lastname: Qin
authors.forename: Yi-Peng
authors.initials: YP
authors.lastname: Song
authors.forename: Xiang-Ming
authors.initials: XM
authors.lastname: Chen
authors.forename: Chuan-Guo
authors.initials: CG
authors.lastname: Hao
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D019583:Dose Fractionation, Radiation; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D011832:Radiation Injuries / Q000175:diagnosis; D020266:Radiotherapy, Conformal; D015996:Survival Rate; D013899:Thoracic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*
chemical_list: D017239:Paclitaxel; D002945:Cisplatin