Published online Jun 15, 2003. doi: 10.3748/wjg.v9.i6.1374
Revised: January 1, 2003
Accepted: January 8, 2003
Published online: June 15, 2003
AIM: This retrospective study was designed to analyze the results and the failure patterns of late course accelerated hyperfractionated radiotherapy for clinical T1-2N0M0 esophageal carcinoma.
METHODS: From Aug. 1994 to Feb. 2001, 56 patients with clinical T1-2 esophageal carcinoma received late course accelerated hyperfractionated radiotherapy in Cancer Hospital, Fudan University. All patients had been histologically proven to have squamous cell carcinoma (SCC) and were diagnosed to be T1-2N0M0 by CT scan. All patients were treated with conventional fractionation (CF) irradiation during the first two-thirds course of the treatment to a dose of about 41.4Gy/23fx/4 to 5 wk, Which was then followed by accelerated hyperfractionation irradiation using reduced fields, twice daily at 1.5Gy per fraction, to a dose about 27Gy/18 fx. Thus the total dose was 67-70Gy/40-43fx/40-49 d.
RESULTS: The 1-, 3- and 5-year overall survival was 90.9%, 54.6%, 47.8% respectively. The 1-, 3- and 5-year local control rate was 90.9%, 84.5% and 84.5%, respectively. Twenty-five percent (14/56) patients had distant metastasis and/or lymph nodes metastasis alone. Eight point nine percent (5/56) patients had local disease alone. Another 3.6% (2/56) patients had regional relapse and distant metastasis.
CONCLUSION: Late course accelerated hyperfractionated radiotherapy is effective on clinical T1-2 esophageal carcinoma. The main failure pattern is distant metastasis.