[Method of dynamic dosage fractionation in preoperative radiation therapy of esophageal cancer].

Dynamic dose fractionation in preoperative radiation therapy in 53 esophageal cancer patients comes down to the following: in the first 3 days a daily tumor dose was 4 Gy, then a daily dose was 2 Gy with a summary focal dose up to 36-42 Gy. Therapeutic results for 127 patients served as control using the routine fractionation schedule: 2 Gy daily (5 times a week) up to a summary focal dose of 40-45 Gy. The irradiated area included almost the entire length of the organ with the regional lymphatic collector. Good tolerance of the method of dynamic dose fractionation was noted: no increased frequency and severity of radiation reactions and complications were noted. The use of the new method made it possible to reduce the periods of preoperative irradiation and rehabilitation. Considerable tumor regression after the use of the above method was observed in 69 +/- 8.7% of the patients, in the control group in 38.9 +/- 8.2% only. A simultaneous increase in the degree of radiation injury of tumors was noted in the study group (3rd-4th degree of radiation pathomorphism in 89.5 +/- 4.5% of the tumors); in the control group in 70.4 +/- 4.4%. Resectability did not differ significantly in both groups. The use of dynamic dose fractionation brought about improved results of combined treatment in general: an increase in the 2-year survival rates by 1.5 himes (59.2 +/- 6.7% as compared to 34.7 +/- 4.2%) was noted.