Choice of fractionation regimen in radiotherapy of inoperable esophageal cancer

The results of definitive radiation treatment for 303 patients with inoperable esophageal cancer were analyzed. Four regimens of fractionation were used: (1) accelerated hyperfractionation (AHF) (70)--1.3 Gy, twice a day, 5 weeks, to a total of 57.2-70 Gy; (2) AHF (49)--1.5-d = 1.5 Gy to a total of 54-63 Gy; (3) AHF (37)--1.7-d = 1.7 Gy to a total of 56.1-57.83 Gy and (4) standard fractionation (SF) (147) to a total of 58-70 Gy. The complete regression rate in the AHF groups (1.3-1.7, 69, 61 and 73%, respectively) was significantly higher than in that of SF (38%) (p(0.01); the median survival in the AHF groups and SF--21, 22, 12.3 and 14.3 months, respectively, and the 5-year survival 14, 12, 4 and 0%, respectively; all the differences in the groups 1.3 and SF were significant. The common independent prognostic factors for all patients were age (p = 0.04), immediate effect of radiation therapy (p = 0.01) and the length of tumor (p = 0.02).