ABSTRACT
Objective To explore the treatment effect and failure patterns associated with different clinical target volume on patients with esophageal carcinoma treated with 5-filed intensity modulated radiotherapy (IMRT), and to determine whether involved field irradiation (IFI) is practicable in these patients. Methods A total of 88 patients with esophageal carcinoma between January 2012 to June 2014 underwent IMRT in our hospital, were divided into IFI group and elective nodal irradiation(ENI) group according to the CTV range for a concurrent control study. Results One-year and two-year survival rate in IFI group and ENI group were 75.0%, 45.5% and 70.5%, 43.2% respectively (P > 0.05). Local failure rate in IFI and ENI groups was 27.3% and 22.7% respectively, distant metastasis failure rates 22.7% and 18.2% respectively and regional failure rate outside the radiation field 11.4% and 4.5%, which showed no statistical difference (P > 0.05). Subgroup analysis indicated failure outside the radiation field tended to increase for primary lesion located in the up thoracic or clinical stageⅠ in IFI group. The volume dose histogram of lung V5, V20, V30 and mean lung dose of ENI group were greater than that of IFI group, while V5 of lung and the mean lung dose had statistical difference. Conclusions The survival rate and local control rate have no significant differencein IFI group and ENI group, so IFI is feasible for some esophageal carcinoma, but it should be cautious to choose IFI for those primary lesion located in the up thoracic or clinical stageⅠ.
ABSTRACT
Objective:To retrospectively analyze the treatment effect and the patterns of failure associated with different clinical target volume on patients with esophageal cancer treated with three dimensional conformal or intensity modulated radiotherapy, and to determine whether involved field radiotherapy is practicable in these patients. Methods:A total of 68 patients with esophageal squa-mous cell carcinoma between January 2007 to June 2011 in our hospital underwent three dimensional conformal or intensity modulated radiotherapy, according to the CTV range is divided into lymph involved-field group (involved field group) and lymph extended field group (extended field group). Results:In Involved field group and expand field group the survival rate of 1, 2 years were 59%, 41%and 61%, 39% respectively (P=0.56), and local control rates were 66%, 48% and 68%, 49% respectively(P=0.78). The total failure rates of involved field and the expand field were 63%and 66%(P=0.89). The local failure rate was 53%and 59%, distant metastasis failure rates were 47%and 44%, the regional failure rates were 11.8%and 7.5%in Involved field and the expand field, there were no difference in Statistics (P=0.39). The lung V10, V20, V30 and mean lung dose of extended field group were greater than that of the in-volved field group, while the mean lung dose and V10 has statistical difference. Conclusion:The involved field group was similar as the extended field group in the survival rate and local control rate, the regional recurrence and distant metastasis are the main cause of treatment failure, so the involved field radiotherapy is feasible for locally advanced esophageal carcinoma.