Three dimensional conformal radiation therapy for esophageal carcinoma

Objective To evaluate the results and side effects in three dimensional conformal radiation therapy (3DCRT) for esophageal carcinoma. Methods From December 1996 to December 1998,67 patients with esophageal carcinoma were treated with 3DCRT(3DCRT group),in which all were treated once every other day to a total dose of 40 42 ?Gy in 13 15 days at 5 6?Gy per fraction totally 7 8 fractions, and during the same interval, another 112 patients treated by conventional fractionation radiotherapy(CF group) to a total dose of 64 68?Gy over 44 48 days at 2.0?Gy per fraction 5 days per week were analyzed and compared. Results The 1 ,2 ,3 and 4 year local control rates in 3DCRT group were 71.6% ,62.7%,49.3% and 43.3% ,compared to 53.6%, 43.8% ,33.9% and 25.9% in CF group (P = 0.011). And the survival rates in 1 ,2 ,3 and 4 years in 3DCRT group were 62.7%,52.2%,43.3% and 38.8%, as compared with 49.1%, 41.1% ,30.4% and 22.3% in CF group (P = 0.027). However, in the 3DCRT group, the incidence of acute radiation esophagitis was higher (P=0.003) and those of hematogenous side effects and B symptom were lower(P=0.007,0.021). Conclusion Compared with conventional fractionation radiotherapy,3DCRT is able to improve the local control rate of esophageal carcinoma, with tolerable acute and late radiation side effects.