Abstract:
To evaluate the efficacy and acute radiation injury in stage IV esophageal cancer patients after radiation therapy with varying doses. Methods: A total of 44 patients with clinical stage IV esophageal squamous cell carcinoma who underwent high- or low-dose radiotherapy of the cancer with synchronized chemotherapy in General Hospital of Chengdu Military Command of PLA between January 2006 and April 2009 were enrolled. The patients were divided into two groups: the patients who underwent high-dose radiotherapy were assigned as Group A D99GTV: ( 6271.43 ± 167.17 ) cGy, D95PTV: (5862.17 ± 247.64 ) cGy , and those with low dose irradiation D99GTV: ( 5269.77 ± 721.64 ) cGy, D95PTV: ( 4731.37 ± 862.21 ) cGy were in Group B. The overall survival ( OS ) rates and radiation injury were evaluated retrospectively, including the correlation factors that affected survival. Results: The total effective rate and local control rate were significantly higher in Group A than in Group B ( P < 0.01 ). The 1-, 2-, and 3-year overall survival ( OS ) rates were 63.6%, 40.1%, and 7.7% in Group A, and 41.9%, 10.9%, and 1.4% in Group B ( P = 0.003 ). There was a significantly prolonged survival time in Group A than in Group B ( P = 0.003 ). OS was correlated with patient age, dose of radiation therapy, and history of smoking and alcohol intake ( P < 0.001 ). Acute radiation-related esophagitis was more serious in Group A than in Group B ( P < 0.05 ). However, there were no differences between the groups in terms of lung injury and bone marrow suppression. Conclusion: High-dose radiotherapy conducted for stage IV esophageal cancer patients with pretherapeutic PS scoring ≤ 1 can apparently increase the local control rate, overall effectiveness, and OS of the disease. There is a high beneficial rate of OS rate in patients ≤60 years that are undergoing high-dose radiotherapy and without a history of smoking or alcohol intake. The incidence rate of the acute radiation injury is clinically tolerated among patients who undergo high-dose irradiation.