Concurrent chemotherapy for esophageal carcinoma treated with three-dimensional conformal radiotherapy

OBJECTIVE:To observe the acute side effects and therapeutic effect of concurrent chemoradiotherapy and radiotherapy alone for patients with esophageal carcinoma.METHODS:Totally 155patients with esophageal carcinoma were observed for the concurrent control study,77of them were treated with concurrent chemoradiotherapy and 78of them received 3DCRT or IMRT alone.The median prescription dose for the two groups was both 60Gy.The regimen of LFP was selected for the concurrent chemoradiotherapy group,side effects,local control rate and survival rate were observed and subsets analysis were performed.RESULTS:The incidence of side effects in concurrent chemoradiotherapy group was higher than that of radiotherapy alone group(P0.05).The incidence of≥2grade esophagitis were 51.95%(40 / 77) and 24.36%(19 / 78) for the two groups(χ 2 = 12.510,P=0.000).The incidence of severe radiation pneumonitis for the two groups were 15.58%(12 / 77) and 3.85%(3 / 78),respectively(χ 2 =6.108,P=0.013).2) The 1,2,3,4-year local control rates of concurrent chemoradiotherapy group and radiotherapy alone group were overall survival rates of the two groups.Subsets analysis did not find a subgroup which had a local or survival profit from the concurrent chemoradiotherapy.3) Local control failure were still the main cause of death,the ratio of patients died of metastasis was 28.6%(10 / 35) and 32.6%(14 / 43) in the concurrent chemoradiotherapy group and radiotherapy alone group respectively(χ 2 =0.144,P=0.704).CONCLUSIONS:The treatment of concurrent chemoradiotherapy may produce severe side effects.The local control rate,overall survival rate and median survival time of concurrent chemoradiotherapy are better,but there is no significant difference.The addition of concurrent chemotherapy for esophageal carcinoma need further investigate.