title: Postoperative intensity-modulated radiotherapy improved survival in lymph node-positive or stage III thoracic esophageal squamous cell carcinoma.
abstract: BACKGROUND
  The aim of this study was to retrospectively analyze the effect of postoperative intensity-modulated radiotherapy (IMRT) on recurrence and survival in lymph node-positive or stage III thoracic esophageal squamous cell carcinoma (TESCC) patients, and evaluate its role in TESCC therapy.
  
  
  METHODS
  We enrolled 538 patients who underwent radical resection with (S + R) or without (S) postoperative IMRT. The median total postoperative IMRT dose was 60 Gy. The Kaplan-Meier method, log-rank test, and chi-square test were used for survival rate calculation, univariate analysis, and sites of failure analysis, respectively.
  
  
  RESULTS
  The 5-year overall survival (OS) and disease-free survival rates were 32.7 and 27.3%, respectively. The 5-year OS rates of lymph node-positive S and S + R patients were 28.4 and 38.8%, respectively (p < 0.001). The 5-year OS rates of stage III S and S + R patients were 24.0 and 38.0%, respectively (p = 0.001). Postoperative IMRT resulted in significantly decreased intrathoracic and supraclavicular recurrence, and obviously delayed median local recurrence and systemic metastases. Systemic metastases increased following postoperative IMRT.
  
  
  CONCLUSIONS
  Postoperative IMRT reduces local recurrence and improves survival in lymph node-positive or stage III TESCC patients, providing a rationale for selection criteria for postoperative IMRT in TESCC.
authors: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Wencheng
authors: W
authors: Zhang
authors: Xiao
authors: X
authors: Liu
authors: Zefen
authors: Z
authors: Xiao
authors: Hongxing
authors: H
authors: Zhang
authors: Dongfu
authors: D
authors: Chen
authors: Qinfu
authors: Q
authors: Feng
authors: Zongmei
authors: Z
authors: Zhou
authors: Jima
authors: J
authors: Lv
authors: Jun
authors: J
authors: Liang
authors: Zhouguang
authors: Z
authors: Hui
authors: Lvhua
authors: L
authors: Wang
authors: Weibo
authors: W
authors: Yin
authors: Guiyu
authors: G
authors: Cheng
authors: Kelin
authors: K
authors: Sun
authors: Xiangyang
authors: X
authors: Liu
authors: Dekang
authors: D
authors: Fang
authors: Jie
authors: J
authors: He
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care; D011184:Postoperative Period; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate