PURPOSE: To describe patient characteristics and the process of
radiotherapy (RT) for patients with
esophageal cancer treated between 1999 and 2001 in Japan. METHODS AND MATERIALS: The Japanese Patterns of Care Study (PCS) Working Group conducted a third nationwide survey of 76 institutions. Detailed information was accumulated on 621 patients with
thoracic esophageal cancer who received RT. RESULTS: The
median age of patients was 68 years. Eighty-eight percent were male, and 12% were female. Ninety-nine percent had
squamous cell carcinoma histology. Fifty-five percent had the main
lesion in the middle
thoracic esophagus. Fourteen percent had clinical Stage 0-I disease, 32% had Stage IIA-IIB, 43% had Stage III, and 10% had Stage IV disease.
Chemotherapy was given to 63% of patients; 39% received definitive chemoradiotherapy (CRT) without
surgery and 24% pre- or postoperative CRT. Sixty-two percent of the patients
aged >/=75 years were treated with RT only.
Median total dose of external RT was 60 Gy for definitive CRT patients, 60 Gy for RT alone, and 40 Gy for preoperative CRT. CONCLUSIONS: This PCS describes general aspects of RT for
esophageal cancer in Japan.
Squamous cell carcinoma accounted for the majority of patients. The standard total external RT dose for
esophageal cancer was higher in Japan than in the United States. Chemoradiotherapy had become common for
esophageal cancer treatment, but patients
aged >/=75 years were more likely to be treated by RT only.
