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Open Access Research article

Feasibility of intensity-modulated and image-guided radiotherapy for locally advanced esophageal cancer

Nam P Nguyen1*, Siyoung Jang9, Jacqueline Vock2, Vincent Vinh-Hung3, Alexander Chi4, Paul Vos5, Judith Pugh6, Richard A Vo7, Misty Ceizyk9, Anand Desai8, Lexie Smith-Raymond9 and the International Geriatric Radiotherapy Group

Author Affiliations

1 Department of Radiation Oncology, Howard University Hospital, 2401 Georgia Avenue, N.W., Room 2055, Washington, DC 20060, USA

2 Department of Radiation Oncology, Lindenhofspital, Bern, Switzerland

3 Department of Radiation Oncology, University Hospitals of Geneva, Geneva, Switzerland

4 Department of Radiation Oncology, University of West Virginia, Morgantown, WV, USA

5 Department of Biostatistics, East Carolina University, Greenville, NC, USA

6 Department of Pathology, University of Arizona, Tucson, AZ, USA

7 Department of Pediatry, University of Virginia, Charlottesville, VA, USA

8 Department of Radiation Oncology, Akron City Hospital, Akron, OH, USA

9 Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA

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BMC Cancer 2014, 14:265  doi:10.1186/1471-2407-14-265

Published: 17 April 2014



In this study the feasibility of intensity-modulated radiotherapy (IMRT) and tomotherapy-based image-guided radiotherapy (IGRT) for locally advanced esophageal cancer was assessed.


A retrospective study of ten patients with locally advanced esophageal cancer who underwent concurrent chemotherapy with IMRT (1) and IGRT (9) was conducted. The gross tumor volume was treated to a median dose of 70 Gy (62.4-75 Gy).


At a median follow-up of 14 months (1-39 months), three patients developed local failures, six patients developed distant metastases, and complications occurred in two patients (1 tracheoesophageal fistula, 1 esophageal stricture requiring repeated dilatations). No patients developed grade 3-4 pneumonitis or cardiac complications.


IMRT and IGRT may be effective for the treatment of locally advanced esophageal cancer with acceptable complications.

Esophageal cancer; Tomotherapy; Normal tissue sparing