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Open AccessArticle

Three-Dimensional Conformal Radiotherapy-Based or Intensity-Modulated Radiotherapy-Based Concurrent Chemoradiotherapy in Patients with Thoracic Esophageal Squamous Cell Carcinoma

1
Division of Thoracic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 106, Taiwan
2
Department of Hemato-Oncology, Wan Fang Hospital, Taipei Medical University, Taipei 106, Taiwan
3
Department of Internal Medicine, School of Medicine, College of Medicine, 106 Taipei Medical University, Taipei 106, Taiwan
4
Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 106, Taiwan
5
School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei 106, Taiwan
6
Department of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei 106, Taiwan
7
Ph.D. Program for Translational Medicine, Taipei Medical University, Taipei 106, Taiwan
8
Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
9
Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
10
Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei 106, Taiwan
11
Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 106, Taiwan
*
Author to whom correspondence should be addressed.
These authors have contributed equally to this study.
Cancers 2019, 11(10), 1529; https://doi.org/10.3390/cancers11101529
Received: 13 July 2019 / Revised: 27 September 2019 / Accepted: 30 September 2019 / Published: 10 October 2019
(This article belongs to the Special Issue Esophageal Squamous Cell Carcinoma)
Background: To date, intensity-modulated radiation therapy (IMRT) with concurrent chemoradiotherapy (CCRT) and CCRT with standard fractionation three-dimensional conformal radiation therapy (3D-CRT) have not been compared. In this study, the outcomes of IMRT-based concurrent CCRT and those of 3D-CRT-based CCRT were compared in patients with thoracic esophageal squamous cell carcinoma (TESCC). Methods: We enrolled 2062 patients with TESCC who had received CCRT and categorized them into two groups on the basis of their treatment modality: Group 1 (3D-CRT-based CCRT) and Group 2 (IMRT-based CCRT). Results: Multivariate Cox regression analysis indicated that the American Joint Committee on Cancer advanced stages (≥IIIA) and 3D-CRT were significant independent predictors of poor outcomes in patients with TESCC who received definitive CCRT. Moreover, receiving IMRT-based CCRT (adjusted hazard ratio [aHR]: 0.88, 95% confidence interval [CI]: 0.78–0.98) was a significant independent prognostic factor for overall survival (p = 0.0223). In Group 2, aHRs (95% CIs) for overall mortality at early (IA–IIB) and advanced clinical stages were 0.91 (0.67–1.25, p = 0.5746) and 0.88 (0.77–0.99, p = 0.0368), respectively. Conclusion: IMRT-based CCRT resulted in higher survival rates in patients with advanced clinical stages of TESCC (i.e., IIIA–IIIC), namely, clinical T3, clinical T4, or lymph node involvement. View Full-Text
Keywords: thoracic esophageal cancer; squamous cell carcinoma; intensity-modulated radiation therapy; concurrent chemoradiotherapy; three-dimensional conformal radiation therapy thoracic esophageal cancer; squamous cell carcinoma; intensity-modulated radiation therapy; concurrent chemoradiotherapy; three-dimensional conformal radiation therapy
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Lin, W.-C.; Chang, C.-L.; Hsu, H.-L.; Yuan, K. .-P.; Wu, A.T.H.; Wu, S.-Y. Three-Dimensional Conformal Radiotherapy-Based or Intensity-Modulated Radiotherapy-Based Concurrent Chemoradiotherapy in Patients with Thoracic Esophageal Squamous Cell Carcinoma. Cancers 2019, 11, 1529.

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