Objective To investigate the effect of selective increase of the single dose of PTV on the prognosis of patients with esophageal cancer.

Methods A total of 302 patients with esophageal cancer who were treated in the Fourth Hospital of Hebei Medical University. The prognostic factors of the whole group were analyzed, and the composition ratios of the two groups with different single doses of PTV were compared. According to the Cox multi-factor analysis results, the PSM method was used for 1:1 matching, and the prognostic factors of the matched two groups were analyzed.

Results The median OS of the whole group was 30.0 months (HR: 3.319, 95%CI: 23.495-36.505), and the median DFS was 21.3 months ( HR: 1.838, 95%CI: 7.698-24.902). Multivariate analysis showed that chemotherapy, cTNM staging, and the single dose of PTV were independent prognostic factors for OS (all P < 0.05) and DFS (all P < 0.05). According to the multivariate analysis results, 90 patients in each group were compared with 1:1 after PSM. After PSM, multivariate analysis results showed that cTNM staging and the single dose of PTV were the independent prognosis influencing factors of OS; chemotherapy, cTNM staging and the single dose of PTV were the independent prognostic factors of DFS; there was no significant difference in ≥2 grade acute side effects between the two groups (all P > 0.05). Subgroup analysis of patients with a single dose of 2Gy and > 2Gy in the SIB-IMRT group showed that the OS and DFS of the latter were significantly better than the former (all P < 0.05).

Conclusion The selective increase of the single dose of PTV could improve the survival of patients undergoing radicalized esophageal cancer without increasing the side effects.