Three-dimensional conformal radiotherapy of early stage esophageal carcinoma

Objective: To analyze the result of 3-dimensional conformal radiotherapy (3DCRT) and operation of early stage esophageal carcinoma. Methods: Ninety-three patients with early stage esophageal carcinoma were treated with 3DCRT from October 2000 to December 2006. The total dose was 50 -70 Gy/25 -35F/5 -7 w. Toxicities and survival rates were evaluated by Kaplan Meier method and the factors of death were analyzed. Results: In the 3DCRT group, 79, 42 and 13 cases were followed up for at least 1-, 3-, and 5-year, respectively. Follow-up rate was 100%. The 1-, 3-, and 5-year actuarial survival rates were 84% ,50% and 29%, respectively, with a median survival time of 37.0 months. The 1-, 3-, and 5-year local control rates were 83%, 63% and 55%, respectively. The 1-, 3-, and 5-year disease free survival rates were 83%, 49% and 28%, respectively. The 1-, 3-, and 5-year metastasis free survival rates were 84%, 51% and 28%, respectively. There were significant influence on the prognosis of age, the state of food taken before treatment, the pain of chest and back, the disease region, the tumor length in x-ray, the maximum infiltration depth in CT scan, the preliminary curative effect and the no operation in univariate analysis. The Cox multivariate model showed that age, the pain of chest and back, the disease region and the tumor length in X-ray were independent prognostic factors. In the operation group, 80,46 and 16 cases were followed up for at least 1-, 3-, and 5-year, respectively. Follow-up rate was 100%. The 1-, 3-, and 5-year actuarial survival rates were 86%, 62% and 41%, respectively, with a median survival time of 47.8 months. Conclusion: Three-dimensional conformal radiotherapy is one of the best radiation treatment regimen for early esophageal carcinoma. (authors)