Different radiation treatment in esophageal carcinoma: a clinical comparative study

Conventional fractionation radiation therapy (CFRT), 3-dimensional conformal radiation therapy (3DCRT) and intensity modulated radiation therapy (IMRT), are always applied to treat esophageal carcinoma. The purpose of this study was to analyse the therapeutic results and acute radiation side effects of radiotherapy in the treatment of esophageal carcinoma.

From March 2008 to May 2010, 117 patients with esophageal carcinoma treated at our hospital were included into this study. Thirty-eight (32.48%?) patients were treated with CFRT, 32 with 3DCRT and 47 with IMRT. The data were retrospectively collected and analysed.

The objective response rates (complete/CR plus partial response/PR) in the CFRT group, 3DCRT group and IMRT group were 96.88, 92.11, and 91.49%, respectively (p=0.617). Furthermore, the one-year survival of the 3 groups was 77.9, 87.5 and 86.7%, respectively (p=0.193), and the 2-year survival 38.6, 55.1 and 57.7%, respectively (p=0.211). The incidence of acute radiation esophagitis in the IMRT+3DCRT groups was significantly higher compared with the CFRT group (p=0.012) and the incidence of acute radiation- induced pneumonitis, bronchitis and myelosuppression in the IMRT+3DCRT groups were lower compared with the CFRT group (p<0.01, p=0.028, and p=0.01, respectively).

Both IMRT and 3DCRT methods can improve the clinical therapeutic outcome of patients with esophageal carcinoma and decrease the incidence of acute radiation pneumonitis, radiation bronchitis and bone marrow suppression.