139 Important predictors of response determined by surgical staging prior to triple modality therapy for esophageal cancer

To assess the effectiveness of definitive radiotherapy in patients with superficial esophageal cancer and to establish the standard treatment method, we had the second investigation (1991.1995) of the treatment results at 3 I institutions all over the country sequentially to the first survey (1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990))". Materials& Methods:We assessed Radiation method and its results in 259 patients (224 males, 35 females) treated by definitive radiotherapy (RT) for superficial esophageal cancer at 31 institutions m Japan from 1991 to 1995.All the cases were confirmed to have squamous cell carcinoma.The mean age was 67 years old (ranged 37-87).The mean tumor length was 3.9cm (ranged 0.4-30).Tumor location was cervical region in 3 cases, upper thoracic in 25, middle thoracic in 186, lower thoracic in 38, and superspread in 7. Definitive radiotherapy was indicated because of advanced age in 38 cases, morbid conditions in 126, both of them in 23 and of refusal to surgery in 44.Sixty-six cases were assessed for the tumor invasion by endoscopy alone, 63 by endoscopy plus endoscopic ultrasonogmphy (EUS), 18 by endoscopy plus EUS plus esophagography, 43 by biopsy , 6 by endoscopy plus esophagography and 4 by esophagography alone.Tumor invaded to mucosa in 62, to submucosa in 144 and unclassified in 53.One hundred and thirty-six cases were irradiated by external radiotherapy (EX) plus intraluminal radiotherapy (IL) with mean dose 66.7 + 7.3 Gy (ranged 42-88).114 by EX alone with mean dose 62.5 + 6.5 Gy (ranged 40-72) and 9 by IL alone with mean dose 34.3 f 13.8 Gy (ranged 12-65).Median follow-up time was 21.8 months (ranged I .3-72.9).