Phase Ii Study Of Concurrent Chemoradiotherapy With A Modified Target Volumes Delineation Method For Inoperable Oesophageal Cancer Patients

Objective: A Phase II study was designed to test the safety and efficacy of concurrent chemoradiotherapy with a modified target volumes delineation method for inoperable oesophageal cancer patients.Methods: All eligible patients were treated with concurrent chemoradiotherapy. The method of delineating target volume is as follows: Planning gross target volume (PGTV) was defined as the primary gross tumour volume (GTV-t) plus a 3 cm margin longitudinally and a 0.5 cm margin circumferentially, and positive lymph nodes (GTV-n) plus a 0.5 cm margin in all directions. Clinical target volume (CTV) was defined as PGTV plus a 0.5 cm margin in all directions and elective nodal region. Planning target volume (PTV) was defined as CTV plus a 0.5 cm margin in all directions. The dose of PGTV is 54-60 Gy in 27-30 fractions (2 Gy per fraction). The dose of PTV is 48.6-54 Gy in 27-30 fractions (1.8 Gy per fraction). The regimen consists of paclitaxel 135 mg m(-2) on 1 day and DDP 25 mg m(-2) on 3 days per 3 weeks. The patients received 2 cycles of chemotherapy during radiotherapy and 2-4 cycles of chemotherapy after radiotherapy.Results: 34 patients were enrolled in this study. The median follow-up time was 20.9 months (range: 3.7-28.4 months) for all patients. The 1-and 2-year survival rates for all patients were 70.5 and 44.1%, respectively. Clinical complete response was observed in 21 patients (61.8%), cPR was observed in 9 patients (26.5%) and cSD was observed in 4 patients (11.7%).Conclusion: This modified method with concurrent chemotherapy could achieve better locoregional control rate. The 1-and 2-year survival rates of this method were close to the survival rates of the current methods widely adopted. Advances in knowledge: The modified target volumes delineation method can enhance locoregional control rate of concurrent chemoradiotherapy.