A clinical research of intensity modulated radiation therapy combined with TP concurrent chemoradiotherapy for superior segment of esophageal cancer

Objective To evaluate the efficacy,local control rate,survival rate and adverse reaction of intensity modulated radiation therapy (IMRT) combind with Tp concurrent chemoradiotherapy (docetaxel and cisphtin) for superior segment of esophageal cancer.Methods Seventy-eight patients with superior segment of esophageal cancer were divided randomly into IMRT combined with TP concurrent chemoradiotherapy group (chemoradiotherapy group) and single IMRT group (radiotherapy group) by double blind method with 39 cases each.The patients in chemoradiotherapy group received chemoradiotherapy,while other patients in radiotherapy group received only radiotherapy.For both groups,the same radiation technic was given with chemoradiotherapy,the total dose was 6 400 cGy/32 f.For the patients in chemoradiotherapy group were also given with TP concurrent chemotherapy weekly.The efficacy,local control rate,survival rate and adverse reaction was observed.Results Complete remission in 17 cases,partial remission in 20 cases,stable in 2 cases,the total effective rate was 94.9％ (37/39) in chemoradiotherapy group.Complete remission in 9 cases,partial remission in 19 cases,stable in 11 cases,the total effective rate was 71.8％ (28/39) in radiotherapy group.There was significant difference in the total effective rate between two groups(P ＜ 0.05).The 3-year local control rate was 69.2％ (27/39) in chemoradiotherapy group,which was higher than that in radiotherapy group[35.9％(14/39)],and there was significant difference(P ＜ 0.05).The 3-year survival rate was 74.4％(29/39) in chemoradiotherapy group,which was higher than that in radiotherapy group [43.6％(17/39)],and there was significant difference (P ＜0.05).Conclusion IMRT combined with TP concurrent chemoradiotherapy can improve the efficacy,local control me,survival rate of esophageal cancer,but can also increase the acute toxic effect. Key words: Esophageal neoplasms;  Radiotherapy,intensity modulated;  Chemoradiotherapy