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Objective:To assess the safety and efficacy of induction chemotherapy with cisplatin and docetaxel followed by radia-tion concurrent with weekly cisplatin for unresectable, locally advanced esophageal cancer. Methods: Thirty-three patients with T3N0M0 to T4N2M0 thoracic esophageal squamous cell carcinoma without celiac lymph node metastasis were included in the study. They were treated with cisplatin (75 mg/m2 d1, d22) and docetaxel (75 mg/m2 d1, d22) neoadjuvant chemotherapy followed by three-dimensional conformal radiotherapy (60Gy/30F/6w) concurrent with cisplatin (30 mg/m2 d1, 8, 15, 22, 29, 36 from the beginning of radiation). Results:Grade 4 hematological toxicities were observed in 13.33%(4/33) of the patients after the neoadjuvant chemother-apy. No grade 3 or above hepatic or renal toxicities were found. During concurrent chemoradiation, the highest grade 3 hematological toxicities were observed in the erythrocyte, granulocyte, and macrophage at 21.21%(7/33), 15.15%(5/33), and 3.01%(1/33), respec-tively. No grade 2 or above hepatic or renal toxicities were observed. Grade 3 radiation esophagitis was observed in 9.1%(3/33) of the patients, whereas grade 3 and above radiation esophagitis or grade 1 and above acute radiation pneumonitis did not occur. The evalua-tion results after treatment completion were 84.85%(28/33), 12.12%(4/33), and 3.03%(1/33) for CR+PR, SD, and PD , respectively. Two months after treatment completion, the results changed to 75.76%(25/33), 9.10%(3/33), and 15.15%(5/33), respectively. Overall, 15 patients died. The one-year survival rate was 66.4%. Local failure was approximately 46.67%(7/15), whereas the local+distant fail-ure was approximately 26.67%(4/15). Therefore, local failure is the main pattern of failure in esophageal cancer. Conclusion:The re-sults indicate that neoadjuvant chemotherapy with cisplatin and docetaxel followed by radiotherapy concurrent with weekly cisplatin for locally advanced esophageal cancer is safe. Local failure remains the main pattern of failure in esophageal cancer.
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Objective To evaluate the role of radiotherapy in the management of dermatofibrosarcoma protuberans. Methods Between 1995 and 1999, 18 patients with pathologically confirmed dermatofibrosarcoma protuberans were retrospectively analyzed. Nine patients were referred to our hospital for primary treatment and the remaining 9 patients came with recurrent disease. Fifteen of 18 patients received surgery followed by radiotherapy. Among them, 14 patients underwent complete resection and 1 partial resection. Majority of patients received 50～60 ?Gy. One patient received 37.5 ?Gy because he refrained from further treatment. Two patients received 52 ?Gy and 50 ?Gy due to unresectable extensive lesion. One of 18 patients was treated by total resection alone.Results The median of follow up time was 26 months with a range of 0.5～5 years. Sixteen patients (8.9%) are disease free. One patient developed local recurrence and one died of malignant progression. These two patients were treated with radiotherapy alone or surgery only. The local control rates were 100% (15/15) for patients who were treated with surgery and radiotherapy. Conclusions Postoperative radiotherapy is able to decrease the local recurrence rate in dermatofibrosarcoma protuberans.