Original Article High-dose Versus Standard-dose Radiotherapy with Concurrent Chemotherapy in Stages II–III Esophageal Cancer

Objective: In this study, we investigated the effects of radiotherapy 60 Gy in the setting of concurrent chemo-radiotherapy for treating patients with Stages II–III esophageal cancer. Methods: A total of 126 patients treated with 5-fluorouracilbased concurrent chemo-radiother-apy between January 1998 and February 2008 were retrospectively reviewed. Among these patients, 49 received a total radiation dose of,60 Gy (standard-dose group), while 77 received a total radiation dose of 60 Gy (high-dose group). The median doses in the standard- and high-dose groups were 54 Gy (range, 45–59.4 Gy) and 63 Gy (range, 60–81 Gy), respectively. Results: The high-dose group showed significantly improved locoregional control (2-year locor-egional control rate, 69 versus 32%, P, 0.01) and progression-free survival (2-year progres-sion-free survival, 47 versus 20%, P 0.01) than the standard-dose group. Median overall survival in the high- and the standard-dose groups was 28 and 18 months, respectively (P 0.26). In multivariate analysis, 60 Gy or higher radiotherapy was a significant prognostic factor for improved locoregional control, progression-free survival and overall survival. No significant differences were found in frequencies of late radiation pneumonitis, post-treatment esophageal stricture or treatment-related mortality between the two groups