Feasibility and short-term efficacy of simplified intensity-modulated radiotherapy and concurrent chemotherapy for neck and upper thoracic esophageal carcinoma
10.3321/j.issn:1000-467X.2009.12.007
- VernacularTitle:简单调强放射治疗与同期化疗治疗颈及胸上段食管癌可行性研究及近期疗效分析
- Author:
Zhu WEI-GUO
1
;
Yu CHANG-HUA
;
Han JI-HUA
;
Li TAO
;
Zhou XI-LEI
;
Tao GUANG-ZHOU
Author Information
1. 淮安市第一人民医院
- Keywords:
esophageal neoplasm;
simplified intensity-modulated radiotherapy;
chemotherapy;
combined modality;
efficacy
- From:Chinese Journal of Cancer
2009;28(12):1265-1269
- CountryChina
- Language:Chinese
-
Abstract:
Background and Objective: For neck and upper thoracic esophageal carcinoma.three dimensional conformal radiation therapy(3DCRT)does not necessarily meet all clinical requirements while intensity modulated radiation therapy(IMRT)may take up a lot of labour power and material resources.This study was to explore the feasibility of simplified IMPT(sIMRT) and concurrent chemotherapy for neck and upper thoracic esophageal carcinoma,and to jnvestigate the acute toxicities and short-term efficacy of this treatment modality.Methods:sIMRT plans were designed for 30 patients with neck and upper thoracic esophageal carcinoma.Two target volumes were defined:PTV1, which was designed to irradiate to 64 Gy (2.13 Gy×30 fractions);PTV2,which was given to 54 Gy(1.8 Gy × 30).The sIMRT plan included five equiangular coplanar beams. All patients concurrently received DDP+5-FU regimen with radiotherapy on d 1-5 and d29-33. Chemotherapy was repeated for two cycles 28 days after radiotherapy.Results:The treatment was completed for all patients within 6 weeks, and only one patient had Grade 3 acute bronchitis.The complete response(CR)rate was 90.0%(27/30)and the partial response(PR)rate 10.0%(3/30).Overall response was 100%for esophageal lesions and the CR rate 76.5%(13/17).The PR rate was 23.5%(4/17)in lymph node lesions.The major toxicities observed were Grades Ⅰ-Ⅱ leukocytopenia.Conclusions: sIMRT can generate desirable dose distribution for neck and upper thoracic esophageal carcinoma,which is similar to sophisticated IMRT but obviously better than 3D-CRT.The short-term efficacy of sIMRT is satisfactory and its acute toxicities are tolerable.
