Three dimensional conformal radiotherapy concurrent with chemotherapy in recurrence from esophageal carcinoma after radiotherapy

OBJECTIVE:To explore the value of three dimensional conformal radiotherapy concurrent with chemotherapy for recurrence from esophageal carcinoma after radiotherapy.METHODS:Totally 48 cases were divided randomly into radiotherapy group(25 cases) and chemoradiotherapy group(23 cases).Three-dimensional conformal radiotherapy was used with 6 MV X line,4 or 5 coplanar or non-coplanar conformal radiation field,2.0 Gy/time,total dose 46-56 Gy;TP regimen was used for chemotherapy group with docetaxel 60-75 mg/m2,d1+cisplatin 25 mg/m2,d1-d3,intravenously.RESULTS:The total response rate was 80.0%(20/25) in radiotherapy group and 82.6%(19/23) in chemoradiotherapy group,the difference was not statistically significant(χ2=1.23,P=0.281);1,2,3 year survival rate was 52%.0,28.0%,8.0% in radiotherapy group,while the chemoradiotherapy group was 56.5%,47.8%,21.7% respectively,the difference was not statistically significant(χ2=0.89,P=0.269).The occurrence rate of radiation esophagitis、radiation pneumonitisd and Ⅰ-Ⅲ degree bone marrow suppression were 47.8%(11/23),34.8%(8/23),52.2%(12/23) respectively in chemoradiotherapy group,it was significantly higher than that in radiotherapy alone group,which were 16.0%(4/25),8.0%(2/25),16.0%(4/25),the difference was significant(χ2 respectively was 5.65,5.21,7.05,P were 0.029,0.033,0.013).The cause of death in radiotherapy alone group was local failure(60.0%,15/25) and distant metastasis(64.0%,16/25) while it was side effects of treatment in chemoradiotherapy group(43.5%,10/23).CONCLUSION: Chemoradiotherapy can improve survival rates in carefully selected patients who recurred from esophageal carcinoma after radiotherapy.