Treatment Procedure
tumor, tumors
TUMOR, POSTOPERATIVE COMPLICATIONS, TUMOR PROGRESSION, PRIMARY TUMOR, TUMORS
The protocol therapy started with two or three cycles of TPF-induction chemotherapy (intravenous [IV] paclitaxel 135 mg/mAfterward, if curative resection was considered possible on multidisciplinary consultation reassessment, the patient was scheduled for conversion surgery 3–4 weeks after induction therapy. McKeown esophagectomy combined with two-field lymphadenectomy was performed. The grade of postoperative complications was defined according to the Clavien-Dindo classification. In addition, chemoradiotherapy was recommended for patients receiving R1/R2 resection.Concurrent chemoradiotherapy was administered as the main treatment for the patients who had tumors still considered unresectable after reassessment. If no tumor progression occurred during induction chemotherapy, the paclitaxel plus cisplatin (TP) regimen was recommended.The gross tumor volume (GTV) encompassed the primary tumor and enlarged regional lymph nodes, as determined by imaging and endoscopy examinations. The clinical target volume (CTV) was determined by a GTV plus a 0.8- to 1.0-cm lateral margin and a 3.0- to 5.0-cm craniocaudal margin that included subclinical involvement. The planning target volume was defined as a CTV plus a 0.5- to 0.8-cm margin. The total planned dose for the planning target volume was 56–60 Gy in 2-Gy fractions per day 5 days a week. All the patients were irradiated by external beam radiation using 6 to 8-MV photon energies of the intensity-modulated radiation technique.