Treatment outcomes of three-dimensional conformal radiotherapy for esophageal carcinoma

Objective To investigate the clinical results of three dimensional conformal radiotherapy (3DCRT) for esophageal carcinoma, and to analyze the relevant factors. Methods From July 2003 to March 2007, 100 patients with esophageal carcinoma received 3DCRT. The prescribed doses ranged from 56 Gy to 70 Gy with 2 Gy per fraction, 1 fraction per day and 5 fractions per week. The short-term clinical re-salts, side effects, 1-,3- and 5-year local control rates and survival rates were evaluated. The relevant fac-Ions were analyzed. Results The follow-up rate was 1130%. The number of patients who completed the 1-,3- and 5-year follow-up were 100,57 and 19, respectively. The 1-,3- and 5-year local control rates were 78.3%, 51.2% and 37.1%, respectively. The 1-,3- and 5-year overall survival rates were 73.0%, 37.2% and 23.9%, respectively. The 1-,3- and 5-year survival rates were 91%, 54% and 41% for stage Ⅱ disease, 63%, 27% and 13% for stage Ⅲ disease (χ2 =4.53 ,P =0.033 ), respectively. The 5-year survival rates were 31% ,33% and 19% (χ2 =7.04,P=0.030) for patients with GTV length≤5 cm, 5～7 cm and 7 cm, 38% and 16% (χ2 =5.30, P=0.021 ) for those with GTV width ≤4 cm and 4 cm, 31% and 18% ( χ2 = 7.82, P=0.005 ) for those with GTV volume 40 cm 3 and ≤40 cm 3 , respectively. Conclusions The 3DCRT for esophageal carcinoma is effective, which may improve the local control and o-verall survival when compared with the historical data. However, the most common treatment failure is still local recurrence, followed by distant metastases. For patients with nearby tissue and organ invasion, the risk of perforation, bleeding or metastasis after radiotherapy is significantly higher than those with early T-stage disease. Key words: Esophageal neoplasms/radiotherapy; Radiotherapy;  three-dimensional conformal; Prognosis