Abstract: Analysis of Three-dimensional Conformal Radiotherapy (3D-CRT) for EsophagealCarcinoma with or without Nodal MetastasisYuxiang WANG, Shuchai ZHU, Jingwei SU, Juan LI, Zhikun LIU, Wenbin SHENCorrespondence to: Shuchai ZHU, E-mail: sczhu@heinfo.netDepartment of Radiation Therapy, The Fourth Hospital of Hebei Medical Uiversity, Shijiazhuang 050011, ChinaThis work was suported by Funds for Resrach Subjects of Hebei Provincial Health Bureau (06004)Abstract Objective: To explore the prognosis of esophageal carcinoma (EsCa) patients with or without lymph nodemetastasis who underwent 3-dimensional conformal radiotherapy ( 3D-CRT). Methods: From January 2001 to August 2007,208 EsCa patients with or without nodal metastasis were treated with 3D-CRT. Survival rates and related prognostic factorswere restrospectively evaluated using SSPS11.5 software. Results: In this group, it was shown that, based on the ages ofthe patients who suffered from lymph node metastasis and images of CT scanning, the invasion of EsCa was correlatedwith nodal metastasis ( P < 0.05 ). The 1-, 3- and 4-year overall survival rates were 64.4%, 31.1% and 23.8%, respectively,and the median survival time was 18 months. Univariate analysis showed that whether or not lymph node metastasis oc-cured, factors such as food intake before treatment ( common diet/semiliquid diet and liquid diet), lesion length ( ≤5cm/>5cm ) in barium esophagogram, and maximum diameter of the tumor in CT images ( ≤4cm/>4cm ) in patients with stageN0 and N1-2 were all related to the success of radiotherapy. The site of the primary tumor in the patients with stage N0 (supe-rior segment of neck and thorax/ middle and inferior-segment of thorax), chemotherapy and the immediate response in N0cases were significant prognostic factors ( P < 0.05 ). Regardless of N stage ( N0 or N1-2 ), patient sex, patient age and doseof radiotherapy were not related to the prognosis, ( P > 0.05 ). Multivariate analysis revealed that food intake, lymph nodemetastasis, lesion length in barium esophagogram and the maximum diameter of the lesion in CT images were indepen-dent prognostic factors. Conclusions: Lymph node metastasis occurs more readily in younger EsCa patients and those withadvanced tumors. 3D-CRT can be considered an effective and feasible approach for treating EsCa. The response of EsCato 3D-CRT would most likely be optimal in patients with mild obstructions due to food intake, with early detection of inva-sion and without nodal metastasis.Keywords Esophageal neoplasm; Three-dimensional conformal radiotherapy; Lymph node metastasis;Survival analysis; Prognosis