Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Surg. Oct 27, 2026; 18(10): 123247
Published online Oct 27, 2026. doi: 10.4240/wjgs.123247
Published online Oct 27, 2026. doi: 10.4240/wjgs.123247
Multimodal image-guided volumetric modulated arc radiotherapy for postoperative esophageal cancer: A prospective randomized controlled trial
Cai-Xia Gou, An-Mei Zheng, Hai-Xia Song, Qiu-Yan Gou, Na Tao, Department of Radiotherapy, Gansu Provincial Cancer Hospital, Lanzhou 730000, Gansu Province, China
Co-first authors: Cai-Xia Gou and An-Mei Zheng.
Author contributions: Gou CX performed the majority of experiments and wrote the manuscript; Zheng AM designed the study and corrected the manuscript; Gou CX and Zheng AM contributed equally to this manuscript and are co-first authors; Song HX participated in the collection of the human material; Gou QY and Tao N served as scientific advisors. All authors approval the final manuscript.
AI contribution statement: This manuscript has not been generated with the use of AI tools.
Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Gansu Provincial Cancer Hospital.
Clinical trial registration statement: This was a prospective, randomized, controlled trial that investigated the effects of magnetic resonance imaging/computed tomography multimodal image-guided radiotherapy in the treatment of esophageal cancer. The intervention consisted exclusively of optimized radiotherapy practices (e.g., magnetic resonance imaging/computed tomography multimodal image localization, precise dose adjustment, and real-time efficacy monitoring) and did not involve any additional invasive procedures or deviations from standard medical care. Therefore, it did not increase the risk beyond that associated with routine treatment. This study was reviewed and approved by the hospital’s ethics committee. As it was classified as a preliminary exploratory study focused on verifying technical efficacy and did not fall within the scope of an interventional clinical trial, it was not registered with the Chinese Clinical Trial Registry.
Informed consent statement: All patients provided informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author.
Corresponding author: Hai-Xia Song, Department of Radiotherapy, Gansu Provincial Cancer Hospital, No. 2 Xiaoxihu East Street, Qilihe District, Lanzhou 730000, Gansu Province, China. songhaixiahx@163.com
Received: May 15, 2026
Revised: June 16, 2026
Accepted: July 16, 2026
Published online: October 27, 2026
Processing time: 149 Days and 0.7 Hours
Revised: June 16, 2026
Accepted: July 16, 2026
Published online: October 27, 2026
Processing time: 149 Days and 0.7 Hours
Core Tip
Core Tip: This prospective randomized controlled trial (n = 65) demonstrates that multimodal magnetic resonance imaging/computed tomography-guided volumetric modulated arc therapy significantly improves radiotherapy precision and safety compared with conventional computed tomography-guided radiotherapy alone in patients with postoperative esophageal cancer. The experimental group achieved a higher target dose coverage, lower dose deviation, better short-term tumor control, and reduced acute/late adverse reactions. Multimodal image-guided volumetric modulated arc therapy represents a preferred adjuvant radiotherapy strategy.