Feasibility of Elective Nodal Irradiation with Esophageal Squamous Cell Cancer: A Retrospective Analysis from a Single Institute

• Published in: PloS one Vol. 10; no. 12
• Main Authors: Jing, Wang, Zhu, Hui, Guo, Hongbo, Zhang, Yan, Shi, Fang, Han, Anqin, Li, Minghuan, Kong, Li, Yu, Jinming
• Format: Journal Article
• Language: English
• Published: Public Library of Science 04.12.2015
• Subjects: Care and treatment; Comparative analysis; Diagnosis; Elderly patients; Esophageal cancer; Health aspects; Radiotherapy; Risk factors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0143007

We conducted a retrospective analysis to assess the feasibility of involved field irradiation (IFI) in elderly patients with esophageal squamous cell cancer (ESCC). We performed a retrospective review of the records of elderly patients ([greater than or equal to] 70 years) with unresectable ESCC and no distant metastases who received treatment with radiotherapy between January 2009 and March 2013. According to the irradiation volume, patients were allocated into either the elective nodal irradiation (ENI) group or the IFI group. Overall survival (OS), progression-free survival (PFS) and treatment-related toxicities were compared between the two groups. A total of 137 patients were enrolled. Fifty-four patients (39.4%) were allocated to the ENI group and 83 patients (60.6%) to the IFI group, the median doses in the two groups were 60 Gy and 59.4 Gy, respectively. For the entire group, the median survival time (MST) and PFS were 16 months and 12 months, respectively. The median PFS and 3-year PFS rate in the ENI group were 13 months and 20.6%, compared to 11 months and 21.0% in the IFI groups (p = 0.61). The MST and 3-year OS rate in the ENI and IFI groups were 17 months and 26.4% and 15.5 months and 21.7%, respectively (p = 0.25). The rate of grade [greater than or equal to] 3 acute irradiation esophagitis in the ENI group was significantly higher than that in the IFI group (18.5% vs. 6.0%; p = 0.027). Other grade [greater than or equal to] 3 treatment-related toxicities did not significantly differ between the two groups. IFI resulted in decreased irradiation toxicities without sacrificing OS in elderly patients with ESCC.