Abstract:Objective To assess the efficacy and the adverse effects of improved late course accelerated hyperfractionated radiotherapy (LCAHRT) combined with cisplatinbased chemotherapy for locally advanced esophageal squamous cell carcinoma (ESCC). Methods 68 Patients with pathologically confirmed ESCC were enrolled. Conventional fractionation was implemented to 40 Gy/20 fractions, followed by LCAHRT delivered 2 fractions of 1.4 Gy with an interval of 6-8 hours per day to 14 fractions, thus the total dose was 59.6 Gy. Two cycles of cisplatinbased chemotherapy were administered concurrently, followed by two more cycles. The shortterm efficacy of treatment, overall survival for 1, 3, 5year, and treatmentrelated toxicity were evaluated. Results All patients successfully completed LCAHRT and the overall response rate was 91.6% (62/68). The overall survival rate of 1, 3, and 5year was 75.5%, 46.5%, 22.7%, respectively. The incidence of radiation esophagitis (grade 3 or greater) was 26.4%, and no patients developed grade 3 or worse radiation pneumonitis. The radiationinduced skin injury were most of grade 0 or 1. Grade 3 of leucopenia and neutropenia were observed in 29.4% and 7.4% of patients, respectively, and grade 4 were both in 2.9%. During longterm followup, no esophageal stenosis and severe pulmonary fibrosis was developed except for two cases(2.9%) of esophageal mediastinal fistula. Conclusion Late course accelerated hyperfractionated radiotherapy combined with chemotherapy yields promising longterm survival, with lower treatmentrelated toxicity for patients of locally advanced esophageal squamous cell carcinoma.

Key words:Esophageal neoplasms,Radiotherapy,Cisplatin,Survival rate,Adverse effects