• Radiation Therapy
• Oncology Clinical Trials
• Radiology
• Gastrointestinal Cancers

• Radiation Therapy
• Oncology Clinical Trials
• Radiology
• Oncology
• Gastrointestinal Cancers

Esophageal carcinoma treatment response to intensity-modulated radiation therapy (IMRT) was not significantly different from 3-dimensional conformal radiation therapy (3DCRT). Jie Kong, MD, Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China, presented results from this retrospective analysis.

IMRT and 3DCRT are common radiation methods used to treat patients with esophageal cancer at Dr Kong's institution. This retrospective study examined differences in patient response and the extent of dosage to organs at risk (OAR) of these targeted radiation techniques.

Treatment response, overall survival, and dosage of OAR were assessed in 510 consecutive patients. Most patients had squamous cell esophageal carcinoma (92.8%). At the discretion of the radiation oncologist, IMRT was administered to 66 patients and 3DCRT to 444 patients. Regardless of method, patients received roughly 2 Gy per day, 5 days a week and may have received concurrent and/or subsequent chemotherapy.

There were no significant differences in any of the measured outcomes between IMRT and 3DCRT. Overall survival rates were similar (27.3% vs 23.4%), as were 1-year (72.7% vs 68.2%) and 5-year (32.3% vs 25.5%) survival rates. Although the complete response rate for patients treated with IMRT was slightly higher than 3DCRT (60.6% vs 53.2%), it was not statistically different.

The dosage of OAR in the lung and heart showed no overall differences, but there was less variation for IMRT vs 3DCRT. The median percentage of pulmonary volume receiving radiation > 20 Gy for IMRT) was similar to 3DCRT (25.2 vs 24) but showed less variation (Q1-Q3 range, 22.6–26.9 for IMRT vs 18.6–27.4 for 3DCRT). The V40 for the heart was also more variable with IMRT (median 20.2; range, 5.9–28.4) compared with 3DCRT (median 17.3; range, 11.2–40.4).

Dr Kong concluded that IMRT was no more effective than 3DCRT, but further investigation of the variability of dosage of OAR may be warranted.

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