Radiotherapy and chemoradiotherapy in patient with N1 esophageal carcinoma

Purpose:To compare the survival and toxicities of concureent chemoradiotherapy followed by adjuvant chemotherapy in patients with N1 esophageal carcinoma. Analysis was made for reasons of failure in the patients with N1 esophageal carcinoma. Methods:From August 1998 to August 2000,65 eligible patients with N1 esophageal carcinoma were randomized into the following arms: 33 patients were randomized to concurrent chemoradiotherapy arm, 32 patients to radiotherapy followed by chemotherapy. The schedules of radiotherapy were the same, which were conventional fractionation, total dose 60～70 Gy. The regimen of chemotherapy all consisted of DDP and 5 FU,4 cycles. It started on the first day of radiotherapy, and 15 days after radiotherapy chemoradiotherapy was given. Results:The survival rates at 1,2 and 3 years were 60.2%,43.5% and 25.9% in the concurrent chemoradiotherapy arm, 66.3%, 22.5% and 11.3% in the radiotherapy followed by chemoradiotherapy arm, respectively ( P =0.109). 18.2% in the radiotherapy followed by chemoradiotherapy arm had grad Ⅲ esophagitis, while the concurrent group had 43.7% P 0 05.Conclusions:Concurrent chemoradiotherapy increased severity of acute esophagitis, and may increase survival rate compared with radiotherapy followed by chemoradiotherapy in patient with N1 esophageal carcinoma.