A comparative study of different irradiation ranges in radical radiotherapy for early-stage esophageal cancer / 中华放射肿瘤学杂志

ABSTRACT

Objective To compare the efficacy of elective nodal prophylactic irradiation ( ENI) and involved?field irradiation ( IFI) in radical radiotherapy for early?stage esophageal cancer and to determine the appropriate irradiation range for early?stage esophageal cancer. Methods The clinical data of 121 patients with early?stage esophageal cancer receiving radical radiotherapy in our hospital from January 2006 to December 2011 were collected and respectively analyzed. Sixty?one patients received ENI, and the other 60 patients received IFI. The Kaplan?Meier method was used to calculate local control ( LC) and overall survival ( OS) rates;the log?rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The 1?, 3?, and 5?year LC rates in ENI group and IFI group were 81. 1%, 60. 1%, and 57. 5% vs. 64. 5%, 43. 9%, and 27. 2%, respectively ( P=0. 003 ) . The 1?, 3?, and 5?year OS rates in ENI group and IFI group were 86. 9%, 56. 8%, and 34. 8% vs. 86. 7%, 34. 3%, and 19. 1%, respectively ( P=0. 019) . The 1?, 3?,and 5?year overall failure rates in ENI group and IFI group were 22. 3%, 53. 8%, and 63. 2% vs. 43. 3%, 65. 8%, and 78. 8%, respectively ( P=0. 023) . Multivariate analysis showed that irradiation range was the influencing factor for LC and OS. Conclusions As for the radical radiotherapy for early?stage esophageal cancer, ENI can significantly increase LC and reduce locoregional failure, and therefore improve long?term OS.