Generally most of the cases of locally advanced ineradicable thoracic oesophageal squamous cell carcinoma recur within the irradiation fields after chemo radiotherapy. Increasing radiation dose using advanced radiotherapy techniques is expected to improve clinical outcomes and also reduce the chances of local and regional recurrence.
The methods used were such that the set of patients with locally advanced ineradicable thoracic oesophageal squamous cell carcinoma having attributes of good performance status underwent chemo radiotherapy using parallel integrated boost intensity-modulated radiotherapy (SIB-IMRT) along with elective irradiation. This SIB-IMRT was carried out in five dosages per week. The doses were fixed for resectable component as 60 Gy, superficial tumors as 51 Gy and elective nodal regions as 48 Gy. The Dose-limiting toxicity (DLT) were predefined into following grades: as acute grade 3 esophagitis, grade 2 pneumonitis, grade 1 cardiac toxicity and a failure to complete planned radiotherapy within 60 days. Kaplan–Meier method exhibited the estimation of Loco regional control and overall survival of patients. All the DLTs were grade 3 esophagitis. The doses were determined as 66 Gy which was delivered in 30 fractions based on the predefined guidelines and criteria. The DLTs occurred in one of six and two of three patients at doses of 66 and 69 Gy.