Three dimensional conformal radiotherapy for esophageal carcinoma: preliminary report of 104 patients

Objective To evaluate the clinical results of three dimensional conformal radiotherapy (3DCRT) for esophageal carcinoma. Methods From May 1999 to May 2001, 104 patients with pathologically confirmed esophageal carcinoma were randomly divided into conventional radiotherapy (CT) and three dimensional conformal radiotherapy(3DCRT) groups, with 52 patients in each arm. The patients in CT group received conventional radiotherapy in 2.0?Gy/f, 5 fractions a week to a total dose of 70?Gy in 7 weeks. The patients in 3DCRT group were first treated by the same fractionation in CT group to the dose of 40?Gy, and then treated by 3DCRT in 3.0?Gy/f, 5 fractions a week to the total dose of 70?Gy in 6 weeks. Results The 1-and 3-year local control rates were 80.2% and 60.5% in 3DCRT group and 61.6% and 31.7% in CT group(χ2 = 4.87, P 0.05 ). The 1-and 3-year survival rates were 72.4% and 53.4% in 3DCRT group and 51.5% and 27.8% in CT group (χ2=4.19,P 0.05 ). Between the two groups, there was no significant difference in radiation toxicities. Conclusions The 1-and 3-year local control rate and survival rate of patients with esophageal carcinoma treated by three dimensional conformal radiotherapy is superior to conventional radiotherapy. However, longer-term results need further study which involves more patients and prolonged follow-up.