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Objective To compare the dosimetry of three different radiation therapy plans [threedimensional conformal radiation therapy (3DCRT),intensity modulated radiation therapy (IMRT),intensity modulated arc radiotherapy (IMAT)].Methods Selected 15 cases with middle thoracic esophageal cancer,Varian Eclipse 8.6 planning systems were designed with 3DCRT,IMRT,IMAT,3DCRT using 5-8 coplanar radiation fields,IMRT using 7 coplanar radiation fields,IMAT using 2 radians.Three planned dose difference were compared.Results Compared with 3DCRT,IMRT and IMAT were better with heterogeneity index (HI),conformality index (CI),VPTV 95 ％,V5,V20,V35 of total lung,and V30 of heart (t =2.531,P＜ 0.05).There was no statistically significant difference for the V10,V15,V25,V30 mean dose of total lung,the mean dose of heart,the maximum dose of spinal cord,and the minimum dose of PTV among the three plans (t =1.325,P ＞0.05).Conclusion IMAT and IMRT are similar in the middle thoracic esophageal cancer radiotherapy target volume dose coverage and organs at risk protection,they are better than 3DCRT.IMAT in the monitor units and delivery time are less than IMRT.
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ObjectiveTo investigate the correlation factors of cervical lymphatic metastasis in thoracic esophageal squamous cell carcinoma.Methods Data of 62 patients with thoracic esophageal squamous cell carcinoma were retrospectively analyzed.Factors associated with cervical lymphatic metastasis were analyzed by using x2 test and multivariate Logistic regression analysis.ResultsLymphatic metastasis was found in 36 cases (58.1％ ),of which metastasis in cervical lymph node was found in 15 cases(24.2％ ).A total of 1954 lymph nodes were excised,with an average of 31.5 per patient.Of all the lymph nodes,metastasis was found in 187 (9.6％) nodes.Logistic regression showed that tumor location,tumor length,thoracic lymphatic metastasis,the metastasis number of thoracic lymph nodes and thoracic lymphatic metastasis along recurrent laryngeal nerve were independent risk factors of cervical lymphatic metastasis [ OR:1.976 ( 1.436-2.538 ),P =0.035 ; 1.346(1.032-1.683),P =0.041;3.012( 1.572-6.825),P =0.012;2.023( 1.463-4.745),P =0.025 and2.254 ( 1.483-4.952 ),P =0.020,respectively ].Conclusion The independent risk factors of cervical lymphatic metastasis are foundation of selective 3-field lymph node dissection and their validities should be validated in further clinical trials.
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Objective To evaluate the value of postoperative prophylactic radiotherapy for N0 e-sophageal squamous carcinoma. Methods From January 1993 to December 2006,859 patients with patho-logically staged N0 and M0 esophageal squamous cell carcinoma were included in this study. Among them, 760 received surgery alone, and 99 received surgery followed by postoperative radiotherapy. Radiotherapy started within 3 to 4 weeks after surgery. The median total dose was 50 Gy(2 Gy/F,5 F/w). Results In surgery alone group and postoperative radiotherapy group,the 5-yeur overall survival rotes were 72.2% vs 77.4% (X2 =0. 13,P >0.05) for all patients,34.6% vs67.1% (X2 =7.72,P <0.05) forpT4 disease,and 70.2% vs 81.3% (X2 =4.01 ,P <0.05) for tumor length >5 cm. Postoperative radiotherapy could lower the recurrence rate for pT4 patients. Conclusions For patients with NO esophageal squamous carcinoma, postoperative radiotherapy can significantly improve the survival for pT4 and tumor length > 5 cm,and also re-duce the recurrence for pT4 patients.
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Se estudiaron 28 pacientes con carcinoma esofágico primario, excluyendo los adenocarcinomas de cardias y fundus gástrico, entre los años 1990 al 2000 en los hospitales Manuel Ascunce Domenech, Amalia Simoni y Madame Curie de la ciudad de Camagüey, Cuba. El tiempo medio de evolución desde la aparición de los primeros síntomas hasta el diagnóstico fue de 5 3 meses. La mayoría de los casos eran hombres entre los 55-64 años (67, 9 %), y la piel blanca fue la más representativa (60, 7 %). El 75 % ingería bebidas alcohólicas diariamente, mientras que 22 enfermos (78, 6 %) procedían de áreas urbanas. El 21, 4 % tenía lesiones precancerosas previas. El 92,8 % de los pacientes presentó disfagia en el momento del diagnóstico. Otros síntomas importantes fueron: pérdida de peso (87, 7 %), regurgitación (67, 8 %) y dolor retroesternal (50 %). La sensibilidad diagnóstica fue similar para la imagenología y la endoscopia, pero fue del 100 % para la combinación endoscopia, biopsia y citología.
Twenty-eigth patients with primary esophageal neoplasia excluiding adenocarcinomas of cardias and gastric fundus, from 1990 to 2000 at Manuel Ascunce Domenech, Amalia Simoni and Madame Curie Hospitals, of Camagüey city, Cuba, were studied. The mean time of evolution since the diagnosis was the primary symptoms until the diagnosis 5±3 mounths. The great majority of cases were men among 55-64 years old (67, 9 %) and the white skin was the most representative (60, 7 %). The 75 % drank alcohol daily, while 22 sick-patients (78, 6 %) came from urbans areas. The 21, 4 % had previous preneoplasic lesions. The 92, 8 % patients presented dysphagia at the moment of diagnosis. Other important symptoms were lose weight (87, 7 %), regurgitation (67, 8 %), and retrosternal pain (50 %). Diagnostic sensibility was similar for imaging and endoscopy, but it was of 100 % for the endoscopic combination and biobsy and/or cytology.
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Objective Objective To evaluate the response,survival and toxicity of concurrent chemoradiotherapy for patients with inoperable esophageal cancer. Methods Eighty-eight patients with inoperable esophageal cancer were divided randomly into two groups, 43 patients in group R+C received chemoradiotherapy, while 45 patients in group R received radiotherapy only. For both groups, the same radiation technic was carried out by conventional fractionation, to a total dose of 60-65Gy/30-33Fr/6.0-6.5W. For group R+C patients, concurrent chemotherapy(5-Fu 500mg/d1-4,DDP 20mg/d1-4) was given. Results Complete response rate in group R+C was 33%,while in group R, it was 13% (P