Definitive chemoradiotherapy for esophageal cancer: 66 Gy versus 50 Gy, a retrospective study

Purpose. - To compare the influence of radiation dose, high dose versus standard dose, on survival for patients with esophageal carcinomas treated with definitive radiochemotherapy. Patients and methods. - Between 2003 and 2006, 143 consecutive patients with squamous-cell carcinoma and adenocarcinoma, clinical stage I to IVA, treated in two different institutions were retrospectively reviewed, 83 patients had received more than 50.4 Gy, median dose 66 Gy (50.7-72 Gy) and 60 less than or equal to 50.4 Gy, median dose 50 Gy (38-50.4 Gy). Results. - Median age was higher in high dose group (67.6 versus 61.7 years). Nutritional status and stage were better in high dose group with a lower weight loss (5.1 versus 7.9%), a higher body mass index (25.7 versus 22.9), more NO patients (60.2 versus 31.7%) and less stage 111 (27.7 versus 63.3%). Median follow up was 20.8 months (2.8-92.4 months), and 64.9 months (4.2-92.4 months) for the 33 surviving patients. No statistically significant difference was shown for local/locoregional control, disease-free survival. Overall survival at 2-, 3- and 5-year and median survival was respectively 44.7%, 36.8%, 19.1% and 21.2 months in high dose group and 50.8%, 31.6%, 20.7% and 24.6 months in standard dose group (P = 0.9). Conclusion. - No difference was found between the two groups in terms of local/distant control and overall survival. A prospective randomised study is needed. (C) 2013 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.