Regional hyperthermia combined with radiotherapy for esophageal squamous cell carcinoma with supraclavicular lymph node metastasis

// Sheng Liming 1, 2 , Ji Yongling 1, 2 , Wu Qiner 3 , Du Xianghui 1, 2 1 Department of Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China 2 Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, China 3 Department of Hyperthermia, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China Correspondence to: Du Xianghui, email: drduxianghui@gmail.com Keywords: esophageal cancer, regional hyperthermia, radiotherapy, prognosis Received: June 15, 2016     Accepted: November 24, 2016     Published: December 24, 2016 ABSTRACT To assess the efficacy and toxicity of Intensity-modulated radiotherapy (IMRT) and hyperthermia for upper and middle thoracic esophageal squamous cell carcinoma (UMT-ESCC) with supraclavicular lymph node metastasis. A total of 50 patients with UMT-ESCC with supraclavicular lymph node metastasis were evaluated in this retrospective study. All patients received IMRT. Hyperthermia was delivered simultaneously with irradiation, in 45 minutes twice a week for 5-6 weeks. Hyperthermia included supraclavicular lymph node metastasis. Forty-four patients (88.0%) received concurrent chemoradiotherapy based on cisplatin regimens. The most common types of hematological toxicities were anemia (62.0%) and leukopenia (60.0%). Most of these events were grade 1-2 and transient. The 3-year progression-free survival (PFS) rate and overall survival (OS) rate were 34.9% and 42.5%, respectively. Cox regression revealed that tumor length and number of supraclavicular lymph node metastasis were two independent predictors of OS (tumor length: HR=3.65, p=0.008; nodal stage: HR=8.07, p=0.019). The IMRT combined with supraclavicular regional hyperthermia has low toxicity and well tolerated with excellent local control in UMT-ESCC with supraclavicular lymph node metastasis.