Intensity-modulated radiation therapy with concurrent chemotherapy for locally advanced cervical and upper thoracic esophageal cancer
AIM: To evaluate the dosimetry, efficacy and toxicity of intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy for patients with locally advanced cervical and upper thoracic esophageal cancer. METHODS: A retrospective study was performed on 7 patients who were definitively treated...
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Published in | World journal of gastroenterology : WJG Vol. 12; no. 34; pp. 5501 - 5508 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Department of Radiation Oncology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China%Department of Radiation Oncology, the University of Texas M D Anderson Cancer Center, United States%Department of Gastrointestinal Medical Oncology, the University of Texas M D Anderson Cancer Center,United States%Department of Cardiovascular and Thoracic Surgical Oncology, the University of Texas M D Anderson Cancer Center, United States
14.09.2006
Baishideng Publishing Group Co., Limited |
Subjects | |
Online Access | Get full text |
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Summary: | AIM: To evaluate the dosimetry, efficacy and toxicity of intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy for patients with locally advanced cervical and upper thoracic esophageal cancer.
METHODS: A retrospective study was performed on 7 patients who were definitively treated with IMRT and concurrent chemotherapy. Patients who did not receive IMRT radiation and concurrent chemotherapy were not included in this analysis. IMRT plans were evaluated to assess the tumor coverage and normal tissue avoidance. Treatment response was evaluated and toxicities were assessed.
RESULTS: Five- to nine-beam IMRT were used to deliver a total dose of 59.4-66 Gy (median: 64.8 Gy) to the primary tumor with 6-MV photons. The minimum dose received by the planning tumor volume (PTV) of the gross tumor volume boost was 91.2%-98.2% of the prescription dose (standard deviation [SD]: 3.7%-5.7%). The minimum dose received by the PTV Of the clinical tumor volume was 93.8%-104.8% (SD: 4.3%-11.1%) of the prescribed dose. With a median follow-up of 15 rno (range: 3-21 too), all 6 evaluable patients achieved complete response. Of them, 2 developed local recurrences and 2 had distant metastases, 3 survived with no evidence of disease. After treatment, 2 patients developed esophageal stricture requiring frequent dilation and 1 patient developed tracheal-esophageal fistula.
CONCLUSION: Concurrent IMRT and chemotherapy resulted in an excellent early response in patients with locally advanced cervical and upper thoracic esophageal cancer. However, local and distant recurrence and toxicity remain to be a problem. Innovative approaches are needed to improve the outcome. |
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Bibliography: | Intensity-modulated radiation therapy R735 Chemotherapy 14-1219/R Esophageal cancer; Intensity-modulated radiation therapy; Chemotherapy Esophageal cancer Telephone: +1-713-56302300 Fax: +1-713-5632366 Correspondence to: Zhongxing Liao, MD, Department of Radiation Oncology, the University of Texas M D Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 97, Houston, TX 77030, United States. zliao@mdanderson.org |
ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.v12.i34.5501 |