Late-course accelerated hyperfractionated radiotherapy combined with chemotherapy for advanced esophageal carcinoma

Objective To evaluated the treatment results of late-course accelerated hyperfractionated radiotherapy combined with chemotherapy for advanced esophageal carcinoma. Methods 72 patients with advanced esophageal cancer were randomized into two groups. The late-course accelerated hyperfractionated radiotherapy combined with chemotherapy(LCAF+CT)group received the induction chemotherapy for two cycles, followed by conventional fractionation radiotherapy to a dose of 36 Gy, then changed into accelerated hyperfractionated radiotherapy to a total dose of 60 ~ 66 Gy. The conventional fractionation radiotherapy combined with chemotherapy(CF+CT)group received the chemotherapy that it was similar to LCAF+CT group, and used the conventional fractionation radiotherapy to a total dose of 60 ~ 66 Gy. Results The 1-, 3- and 5-year survival rates were 82.3 %, 51.6 %, 38.2 % in the LCAF+CT group, and 73.8 %, 31.5 %, 18.6 % in the CF+CT group. The differences of 3- and 5-year survival rates were statistically significant (P 0.05). The toxic and side effects of the LCAF+CT group were more severe than those of the CF+CT group. The main cause of death was local recurrence and the next cause was distant metastasis in the two groups. The diffierence was not statistically significant(P 0.05). Conclusion Late-coures accelerated hyperfractionated radiotherapy combined with chemotherapy might improve the treatment efficacy of advanced esophageal cancer and lengthen the suvival time. The toxic and side effects of LCAF+CT group were more severe than those of CF+CT group, but they were well tolerable.