Radiotherapy for esophageal carcinoma: dose, response and survival

• Main Authors: Luo Y, Mao Q, Wang X, Yu J, Li M
• Format: Article
• Language: English
• Published: Dove Medical Press 2017-12-01
• Series: Cancer Management and Research
• Subjects: Esophageal cancer; radiation dose; Dose fractionation; Predictive factors; individualization
• Online Access: https://www.dovepress.com/radiotherapy-for-esophageal-carcinoma-dose-response-and-survival-peer-reviewed-article-CMAR

Yijun Luo,1,* Qingfeng Mao,2,3,* Xiaoli Wang,1 Jinming Yu,3 Minghuan Li3 1Department of Oncology, The People’s Hospital of Jiangxi, Nanchang, 2School of Medical and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, 3Department of Radiation Oncology and Radiology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, China *These authors contributed equally to this work Abstract: Esophageal cancer (EC) is an extremely aggressive, lethal malignancy that is increasing in incidence worldwide. At present, definitive chemoradiotherapy is accepted as the standard treatment for locally advanced EC. The EC guidelines recommend a radiation dose of 50.4 Gy for definitive treatment, yet the outcomes for patients who have received standard-dose radiotherapy remain unsatisfactory. However, some studies indicate that a higher radiation dose could improve local tumor control, and may also confer survival benefits. Some studies, however, suggest that high-dose radiotherapy does not bring survival benefit. The available data show that most failures occurred in the gross target volume (especially in the primary tumor) after definitive chemoradiation. Based on those studies, we hypothesize that at least for some patients, more intense local therapy may lead to better local control and survival. The aim of this review is to evaluate the radiation dose, fractionation strategies, and predictive factors of response to therapy in functional imaging for definitive chemoradiotherapy in esophageal carcinoma, with an emphasis on seeking the predictive model of response to CRT and trying to individualize the radiation dose for EC patients. Keywords: esophageal cancer, radiation dose, altered fractionation, predictive factors, individualization