Treatment outcomes of radiotherapy for patients with stage I esophageal cancer: A single institute experience

OBJECTIVES: To evaluate the effectiveness of radiotherapy for patients with stage I esophageal cancer. METHODS: From 1995 to 2005, 34 patients with superficial thoracic esophageal squamous cell carcinoma without lymph node metastasis were treated with radiotherapy at our institute. Patient characteristics were as follows: median age, 68 years; range, 47 to 84 years; male:female, 33:1; performance status, 0/1/2/3 = 23/9/1/1; T1a/T1b = 4/30. Median fraction and total doses of external irradiation given were 2.0 Gy and 60 Gy, respectively. Twenty-three patients had local irradiation to the primary lesion only; the remaining 11 patients received regional field irradiation, including one or 2 regional lymph node areas. Only one patient received adjuvant intracavitary radiotherapy after radiotherapy. Thirty of the patients received concurrent chemotherapy, most of the regimens of which included cisplatin and 5-fluorouracil. Adjuvant chemotherapy was performed in 5 patients. Fifteen patients (44%) had coexisting malignancies. The median follow-up was 38 months (range, 8-107 months). RESULTS: The 5-year overall, cause-specific, and local-progression-free survival rates were 50.4%, 91.2%, and 81.1%, respectively. Of the 34 patients, 6 had in-field local recurrence, and one had recurrence in the esophagus outside of the irradiated field. Two patients experienced regional lymph node metastasis outside of the irradiated field, and one had distant metastasis. Two patients received salvage surgery, and 4 patients received salvage intracavitary radiotherapy after local recurrence. A late toxicity greater than grade 2 was not observed in any patient. CONCLUSIONS: Radiotherapy is an effective treatment modality for patients with stage I esophageal cancer.