Late effects of radiotherapy were assessed using Radiotherapy Oncology Group/European Oncology Research and Treatment Center (RTOG/EORTC) late radiation morbidity scores. In both scoring systems, the grading is between 0 and 5 where 0 denotes “no change” and 5 denotes “death”. Evaluation of resectability and decision of operability were Selleckchem Ganetespib evaluated radiologically

according to WHO criteria 4 weeks after the completion of CRT using thorax computerized tomography and/or PET-CT findings. Following the treatment patients attended follow-up visits Inhibitors,research,lifescience,medical monthly with complete blood count, blood biochemistry, and PA chest X-rays. The decision for surgery was based on the assessment by a multidisciplinary team according to partial/complete radiological response. The selection criterion for operation was resectability. Five patients refused surgery although they had been Inhibitors,research,lifescience,medical evaluated as candidates for operation; seven patients underwent total radical esophagectomy with three-field lymphadenectomy (celiac, mediastinal, cervical) and 8 patients did not receive operation on clinical grounds since they had complete radiological

response. All surgeries Inhibitors,research,lifescience,medical were planned surgery and were performed within 6 to 8 weeks after neoadjuvant therapy. In addition to imaging studies required for surgical evaluation, a thorax computerized tomography was performed 6 month after the treatment. Local control was assessed radiologically in non-surgical patients using the computerized tomography images at 6 month. In surgical patients, local control was evaluated using pathology findings. The overall survival was defined as the time from diagnosis to last follow-up visit or death. Statistical methods Data analysis was performed using Inhibitors,research,lifescience,medical SPSS (Statistical Package for Social Sciences) version 16.0. The primary endpoint of our study included acute-late toxicity and treatment response. Secondary endpoints were local control and overall survival. Categorical data have been presented as number and percent of patients, and overall survival was determined

using Kaplan-Meier method. Results Clinical characteristics of study subjects Inhibitors,research,lifescience,medical are presented in Table 1. All patients had a histologically proven squamous cell carcinoma of the esophagus. Of the 20 patients, 19 (95%) completed 2 courses until of chemotherapy and 1 course of radiochemotherapy, and the remaining one patient did not receive chemotherapy during the last course due to low tolerance. In two patients a 20% dose reduction in chemotherapy was required. Table 1 Patient characteristics (n=20) All patients could receive the planned RT dose of 5760 cGy. The examination of target volumes in conformal planning showed a median tumor volume of 43.9 cc (13.1-147.8 cc; mean 59.9 cc), PTV1 volume of 310.3 cc (136.9-651.2 cc), and PTV2 volume of 265.5 cc (94.8-548.7 cc). The median dose applied to the 95% of the planned target volume was 5760 cGy (5459-6243 cGy).