Treatment for Medium and Late Stage Esophageal Cancer Using Intensity Modulated Radiation Therapy Combined with PF Chemotheraphy

Objective To explore the clinical value of intensity modulated radiation therapy（IMRT）combined with PF chemotherapy for medium and late stage esophageal cancer. Methods Seventy-seven patients with medium and late stage esophageal cancer patients were randomly divided into two groups.37 patients in Group A were treated with intensity modulated radiation therapy plus PF chemotherapy.Forty patients in Group B were treated with conventional radiotherapy plus PF chemotherapy.Both group A and group B received the chemotherapy of PF regimen.All patients received DDP 30 mg/(m2·day)，5-Fu 0.5 g/(m2·day) in the first and fifth week of radiotherapy by Intravenous infusion 3 days. Radiotherapy didn't stop. Radiation dose for all patients were DT66Gy, 6 ~ 7 weeks to complete. Results The overall response rate(CR+PR) was 89.2% in Group A,but 65% in Group B.The χ² value is 7.18 and P<0.05.The 1-year,2-year and 3-year survival rate was 83%,65% and 51% respectively,in Group A. And 72%,53% and 32%,respectively, in Group B.There were significantly statistical difference between two groups(χ²=5.53,P<0.05).Acute radiation-induced esophagitis were not statistical different between two groups(χ²=0.08,P>0.05).The acute radiation-induced pulmonitis in Group A was significantly higher than that in Group B(χ²=8.99,P<0.01). Conclusion Intensity modulated radiation therapy(IMRT）combined with chemotherapy for the treatment of medium and late esophageal cancer has higher efficacy,less side effects and better-tolerance,in contrast with conventional radiotherapy plus chemotherapy.IMRT can increase not only radiation dose for target and local control rate,but also the survival rate without increasing the side effects of radiotherapy.