Three‐dimensional conformal radiation therapy alone for esophageal squamous cell carcinoma: 10‐year survival outcomes

Abstract

Background Concurrent chemoradiation is the standard treatment for locally advanced esophageal squamous cell carcinoma (SCC). We conducted a phase II study to explore the effect of three‐dimensional conformal radiotherapy (3‐DCRT) alone for patients with locally advanced esophageal SCC. This study aimed to analyze the long‐term survival outcomes. Methods Between November 2004 and April 2007, 30 patients with thoracic esophageal SCC underwent late‐course sequential boost 3‐DCRT at Fudan University Shanghai Cancer Center. The planning target volume (PTV1) comprised a 1.2–1.5 cm lateral margin around the gross tumor volume and a 3.0 cm margin, superior and inferior to the gross tumor volume. PTV2 encompassed the gross tumor volume with a margin of 0.5–0.7 cm. The PTV1 dose delivered was 50 Gy, and the PTV2 dose was a boost dose of 16 Gy, resulting in a total dose of 66 Gy. No chemotherapy was administered. Results The median follow‐up time was 30 months for all patients, and 132 months for patients who were alive. The median overall survival was 27 months (95% confidence interval [CI] 18.9–35.0). The 2‐, 5‐, and 10‐year overall survival rates were 56.6%, 33.3%, and 26.6%, respectively. The median progression‐free survival was 14 months (95% CI 7.7–20.2 months), and the 2‐, 5‐, and 10‐year progression‐free survival rates were 33.3%, 30.0%, and 26.6%, respectively. No severe late toxicity was observed in long‐term survivors. Conclusion Late‐course sequential boost 3‐DCRT is safe and feasible with promising long‐term outcomes for esophageal SCC.

Keywords

• Esophageal squamous cell carcinoma
• radiotherapy
• three‐dimensional conformal radiation therapy