Three Dimensional Conformal Radiotherapy with Late Course Accelerated Hyperfractionated for Local Advanced Esophageal Carcinoma

Objective To evaluate the therapeutic effects of three dimensional conformal radiotherapy with late course accelerated hyperfractionated for local advanced esophageal carcinoma.Methods From September 2002 to September 2004,a prospectively randomized trial was carried out on 82 patients with local advanced squamous cell carcinoma of the esophagus which were randomized into two groups:42 in the three dimensional conformal radiotherapy with late course accelerated hyperfractionated(CRTLCAHF) group and 40 in the conventional fractionation(CF) group.Patients in the CRT group received radiation at 2.0Gy/F,5 days per week,40Gy/20F/4wks,then 1.4Gy/F,twice a day(interval of 6 hrs),to a total dose of 59.6～68Gy,5～6wks.Patients in the CF group received conventional fractionation radiotherapy of 2.0Gy per fraction to a total dose of 60～68Gy/30～34F/6～7wks.Results The local control rates at 1 and 3 years were 76.2%,58.6% in the CRT group and 66.7%,28.6% in the CF group(P = 0.0139).The 1 and 3 year survival rates were 69.1%,44.3% in the CRT group and 48.5%,24.7% in the CF group(P = 0.0433).There was no significant differences on acute complications between the two groups(P0.05).Conclusion For local advanced esophageal carcinoma,three dimensional conformal radiotherapy with late course accelerated hyperfractionated can improve the survival rate and local control rate without increasing complications.