title: Efficacy of intensity-modulated radiotherapy for resected thoracic esophageal squamous cell carcinoma.
abstract: BACKGROUND
  Little is known about the clinical use of intensity-modulated radiotherapy (IMRT) in postoperative radiotherapy (PORT) of esophageal cancer; therefore, we retrospectively investigated the clinical value of postoperative IMRT among resected thoracic esophageal squamous cell carcinoma (TESCC) patients.
  
  
  METHODS
  We enrolled a total of 228 patients with resected TESCC who underwent IMRT between January 2004 and June 2009 in the study. PORT was applied via IMRT with a median total dose of 60 Gy. The Kaplan-Meier method was used to calculate survival rates, and a log-rank test was used for univariate analysis. The Cox proportional model was used for multivariate analysis.
  
  
  RESULTS
  The one, three, and five-year overall survival rates of all patients were 89.9%, 56.7%, and 45.1%, respectively. Univariate analysis showed that significant prognostic factors included Union for International Cancer Control 2002 stage, lymphatic metastasis, number of metastatic lymph nodes, the degree of metastatic lymph nodes, the degree of differentiation, and vascular tumor thrombus (P < 0.05). Treatment failure occurred in 98 (45.2%) patients because of recurrence or metastases. Early reactions were observed at rates of 18.0% for radiation esophagitis and 5.7% for radiation pneumonitis more than grade 2. Late side effects included anastomotic stenosis (1.3%) and gastrointestinal bleeding (3.1%).
  
  
  CONCLUSIONS
  The postoperative prophylactic IMRT of TESCC provided a favorable local control rate and acceptable toxicity.
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China ; Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer Tianjin, China.
authors.forename: Wencheng
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Zefen
authors.initials: Z
authors.lastname: Xiao
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Lvhua
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Hongxing
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Dongfu
authors.initials: D
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Zongmei
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Qinfu
authors.initials: Q
authors.lastname: Feng
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Zhouguang
authors.initials: Z
authors.lastname: Hui
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liang
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Weibo
authors.initials: W
authors.lastname: Yin
authors.affiliation: Department of Thoracic Surgical Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: He
keywords: Esophageal neoplasms/surgery; intensity-modulated radiotherapy; postoperative; prognosis