Abstract
Chemoradiotherapy is a major treatment for inoperable esophageal carcinoma (EC). However, there is still controversy over the target volume for radiation, particularly nodal target volume. EC is characterized by a high rate of lymph node metastasis, and its metastatic pattern is not always predictable. Elective nodal irradiation (ENI) will increase the radiation field, which may increase the incidence of adverse events. Some investigators used involved-field irradiation (IFI) to reduce treatment-related toxicities without compromising survival. Studies have demonstrated that regional and distant micrometastases can be controlled, to some extent, by chemotherapy, incidental irradiation, and the abscopal effects of radiation. With either ENI or IFI, EC recurrence is usually found in the primary tumor and at distant sites, without survival difference. These data suggest that IFI is feasible in EC patients. Key words: Esophageal neoplasms/radiotherapy; Involved-field irradiation; Clinical target volume
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