Abstract
BackgroundA retrospective study to compare the failure patterns and effects of elective nodal irradiation (ENI) or involved field irradiation (IFI) for cervical and upper thoracic esophageal squamous cell carcinoma (SCC) patients.MethodsOne hundred and sixty nine patients with the cervical and upper thoracic esophageal SCC were analyzed retrospectively; 99 patients (59%) underwent IFI and 70 patients (41%) received ENI. We defined “Out-PTVifi in-PTVeni metastasis” as lymph node metastasis occurring in the cervical prophylactic field of PTVeni thus out of PTVifi.ResultsOut-PTVifi in-PTVeni cervical node metastasis occurred in 8% of patients in the IFI group, all within 2 years after treatment. However, it occurred in 10% of patients in the ENI group, and these failures happened gradually since one year after treatments. No difference was found in OS and the incidences of Grade ≥ 3 treatment-related esophageal and lung toxicities between the two groups.ConclusionsENI for cervical and upper thoracic esophageal SCC patients did not bring longer OS and better long-term control of cervical lymph nodes. Although ENI might delay cervical nodes progression in elective field; it could not decrease the incidence of these failures.
Highlights
A retrospective study to compare the failure patterns and effects of elective nodal irradiation (ENI) or involved field irradiation (IFI) for cervical and upper thoracic esophageal squamous cell carcinoma (SCC) patients
Failure patterns Failure patterns for the entire group were demonstrated in Table 2 and Figure 1
No significant difference was found between the IFI group and the ENI group regarding in field recurrences (p = 0.866) and distal organ metastasis (p = 0.728)
Summary
A retrospective study to compare the failure patterns and effects of elective nodal irradiation (ENI) or involved field irradiation (IFI) for cervical and upper thoracic esophageal squamous cell carcinoma (SCC) patients. Esophageal carcinoma is one of the most common cancers in the world with an estimated 482,300 new cases and 406,800 deaths yearly worldwide [1]. Definitive chemoradiotherapy is widely used as the standard of care [2,3,4]. Whether ENI should be performed has always been a controversy, especially for cervical and upper thoracic esophageal squamous cell carcinoma (SCC). We retrospectively studied different failure patterns for patients who had ENI and who had not, investigated the effects for them
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