Late course accelerated hyperfractionated radiotherapy for clinical T_(1-2) esophageal carcinoma

摘要

AIM: This retrospective study was designed to analyze the results and the failure patterns of late course accelerated hyperfractionated radiotherapy for clinical T_(1-2)N_0M_0 esophageal carcinoma. METHODS: From Aug. 1994 to Feb. 2001, 56 patients with clinical T_(1-2) esophageal carcinoma received late course accelerated hyperfractionated radiotherapy in Cancer Hospital, Fudan University. All patients had been histologically proven to have squamous cell carcinoma (SCC) and were diagnosed to be T_(1-2)N_0M_0 by CT scan. All patients were treated with conventional fractionation (CF) irradiation during the first two-thirds course of the treatment to a dose of about 41.4Gy/ 23fx/4 to 5 weeks, Which was then followed by accelerated hyperfractionation irradiation using reduced fields, twice daily at 1.5Gy per fraction, to a dose about 27Gy/18 fx. Thus the total dose was 67-70Gy/40-43fx/40-49 d. RESULTS: The 1-, 3- and 5-year overall survival was 90.9%, 54.6%, 47.8% respectively. The 1-, 3- and 5-year local control rate was 90.9%, 84.5% and 84.5%, respectively. Twenty-five percent (14/56) patients had distant metastasis and/or lymph nodes metastasis alone. Eight point nine percent (5/56) patients had local disease alone. Another 3.6% (2/ 56) patients had regional relapse and distant metastasis. CONCLUSION: Late course accelerated hyperfractionated radiotherapy is effective on clinical T_(1-2) esophageal carcinoma. The main failure pattern is distant metastasis.