Background
esophageal cancer, cancers, death
ESOPHAGEAL CANCER, CANCERS, RECURRENCE, OESOPHAGEAL CANCER, DISEASES
Worldwide, esophageal cancer remains one of the most common cancers and the fourth cause of cancer-related death [In recent years, series of clinical trials and large sample size retrospective studies demonstrated that postoperative radiotherapy could play a positive role in esophageal cancer, especially for patients with advanced diseases. Xiao et al. reported that among stage III (T4N0-1M0 or T3N1M0, AJCC 6th) patients, 5-year survival rate of postoperative radiotherapy group was 35.1%, which was much higher than 13.1% in the surgery only group. Additionally, postoperative radiotherapy could reduce the incidence of mediastinal and supraclavicular lymph node recurrence [In the clinical practice of postoperative radiotherapy, the target volumes were various. Xiao et al. set the target volume from bilateral supraclavicular areas to the entire mediastinum and site of anastomosis. As a result, postoperative radiotherapy significantly reduced the recurrence rate of the supraclavicular and mediastinal lymph nodes, while the recurrence rate of abdominal lymph nodes was still high, which was largely attributed to uninvolved the abdominal lymph node area into the irradiation field [In the research of postoperative treatment, adjuvant chemotherapy was also a key point. In JCOG 9204 study, postoperative chemotherapy could prolong the disease-free survival in N+ patients [Based on the reasons above, we designed a single-arm, phase II clinical trial, in which we elevated the total dose to 45 Gy and added concurrent chemotherapy, aiming to improve the local control rate and prolong the survival.