title: Target volume delineation for radical radiotherapy of early oesophageal carcinoma in elderly patients.
abstract: OBJECTIVE
  To compare the prognosis of elderly patients with early oesophageal carcinoma between radical elective nodal prophylactic irradiation and involved-field irradiation and to estimate the failure modes and adverse effects, then to provide the patients the safe and individual therapeutic regimens.
  
  
  METHODS
  The charts of 96 patients aged 65 and over with early stage oesophageal carcinoma receiving radical radiotherapy in our department were retrospectively analysed. Of all the patients, 49 received elective nodal prophylactic irradiation and the other 47 received involved-field irradiation. After completion of the whole treatment, we analysed short-term effects, tumour local control, overall survival of the patients, failure modes and adverse effects.
  
  
  RESULTS
  The 1-, 3-, and 5-year local control rate in elective nodal irradiation and involved-field irradiation groups were 80.6%, 57.4%, 54.0% and 65.4%, 46.5%, 30.5% respectively, and the difference was statistically significant (χ2=4.478, P=0.03). The differences of overall survival and progression-free survival were not significant (P>0.05). The difference of 1-, 3-, and 5-years local regional failure rate was statistically significant between elective nodal prophylactic irradiation and involved-field irradiation groups, except for the overall failure and distant metastasis rates. The overall incidence of radiation-induced oesophagitis after elective nodal irradiation or involved-field irradiation was 79.6% and 59.6%, and the difference was statistically significant (χ2=4.559, P=0.03). The difference of radiation pneumonitis between elective nodal prophylactic irradiation and involved-field irradiation was not significant (12.2% vs 14.9%; χ2=0.144, P=0.7).
  
  
  CONCLUSIONS
  For elderly patients with early stage oesophageal carcinoma receiving radical radiotherapy, although elective nodal prophylactic irradiation could increase the incidence of radiation-induced oesophagitis, patients could tolerate the treatment and benefit from local control.
authors.affiliation: Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China. Electronic address: 704057795@qq.com.
authors.forename: J
authors.initials: J
authors.lastname: Su
authors.affiliation: Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: S
authors.initials: S
authors.lastname: Zhu
authors.affiliation: Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: C
authors.initials: C
authors.lastname: Song
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000517:prevention & control / Q000532:radiotherapy*; D008297:Male; D058958:Organs at Risk; D017564:Radiation Pneumonitis / Q000453:epidemiology / Q000209:etiology; D011881:Radiotherapy, Computer-Assisted / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D002945:Cisplatin; D005472:Fluorouracil
keywords: Cancer de l’œsophage; Early stage; Elderly patients; Elective nodal prophylactic irradiation; Involved-field irradiation; Irradiation des seuls territoires ganglionnaires initialement atteints; Irradiation prophylactique ganglionnaire élective; Oesophageal neoplasm; Patients âgés; Prognosis; Pronostic; Radiotherapy; Radiothérapie; Stade précoce