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World J Gastroenterol. Nov 21, 2006; 12(43): 7047-7050
Published online Nov 21, 2006. doi: 10.3748/wjg.v12.i43.7047
Randomized clinical trial on seven-day-per-week continuous accelerated irradiation for patients with esophageal carcinoma: Preliminary report on tumor response and acute toxicity
Su-Ping Sun, Ya-Zhou Liu, Tao Ye, Wen Zhang, Wen-Bin Shen, Jing-Lei Shi, Hai-Ting Xu, Wei-Dong Wang
Su-Ping Sun, Department of Radiation Oncology, Changzhou Second hospital-The Affiliated Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu Province, China
Ya-Zhou Liu, Tao Ye, Wen Zhang, Wen-Bin Shen, Jing-Lei Shi, Hai-Ting Xu, Wei-Dong Wang, Department of Radiation Oncology, Xuzhou Cancer Hospital, Xuzhou 221005, Jiangsu Province, China
Author contributions: All authors contributed equally to the work.
Supported by the Xuzhou Science and Technology Office, No. X2003024
Correspondence to: Dr. Su-Ping Sun, Department of Radiation Oncology, Changzhou Second Hospital-The Affilicated Hospital of Nanjing Medical University, 29# Xing Long Xiang, Changzhou 213003, Jiangsu Province, China. ssp56@126.com
Telephone: +86-519-8105765 Fax: +86-519-8115560
Received: May 25, 2006
Revised: August 12, 2006
Accepted: August 22, 2006
Published online: November 21, 2006
Abstract

AIM: Tumor response and normal tissue toxicity of seven-day-per-week continuous accelerated irradiation (CAIR) for patients with esophageal carcinoma were evaluated and compared to conventional irradiation (CR).

METHODS: Sixty patients with squamous cell carcinoma of the esophagus were randomized into two groups: the CAIR group (30 patients) and the CR group (30 patients). Patients in the CAIR group received radiotherapy (RT) with 2 Gy/fraction per day at 7 d/wk with a total dose of 50-70 Gy (average dose 64.2 Gy). The overall time of irradiation was 3.6-5.0 wk (average 4.6 wk). RT in the CR group was 2 Gy/fraction per day at 5 d/wk with a total dose of 40-70 Gy (average dose 61.7 Gy). The overall time of irradiation was 4.0-7.0 wk (average 6.4 wk).

RESULTS: The data showed that the immediate tumor response to RT was better in the CAIR group than in the CR group. Efficiency rates (CR plus PR) were 82.8% (24/29) and 58.6% (17/29), respectively (P = 0.047). In both groups the incidences of esophagitis and tracheitis were insignificant (P = 0.376, 0.959), and no patient received toxicity that could not be tolerated.

CONCLUSION: CAIR shortens overall treatment time and is well tolerated by patients. It may be superior to CR in enhancing the local response of tumor, but its remote effect for esophageal carcinoma awaits further follow-up.

Keywords: Esophageal carcinoma, Continuous accelerated irradiation, Conventional irradiation, Toxicity, Overall treatment time