Multimodal image-guided volumetric modulated arc radiotherapy for postoperative esophageal cancer: A prospective randomized controlled trial

doi:10.4240/wjgs.123247

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Randomized Controlled Trial

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

Table 1 Comparison of the radiation dose distribution between the two groups, mean ± SD

Groups	GTV D95% (Gy)	CTV D95% (Gy)	PTV D95% (Gy)	Lung V20 (%)	Lung V30 (%)	Heart V30 (%)	Heart V40 (%)	Spinal cord Dmax (Gy)
Experimental group (n = 32)	55.8 ± 1.2	54.5 ± 1.3	50.2 ± 1.4	18.3 ± 3.2	12.1 ± 2.8	20.7 ± 3.1	12.3 ± 2.9	45.8 ± 1.6
Control group (n = 33)	52.3 ± 1.5	47.6 ± 1.7	47.6 ± 1.7	22.5 ± 3.7	15.4 ± 3.0	24.6 ± 3.5	15.7 ± 3.2	49.3 ± 1.8
t	10.368	18.340	6.719	4.888	4.581	4.750	4.484	8.276
P value	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01

GTV: Gross tumor volume; CTV: Clinical target volume; PTV: Planning target volume; D95%: Differences in dose coverage; Dmax: Maximum dose.

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Table 2 Comparison of radiation dose deviation between the two groups, mean ± SD

Groups	Mean dose deviation (%)	SD of dose deviation (%)
Experimental group (n = 32)	2.3 ± 0.5	1.1 ± 0.3
Control group (n = 33)	4.6 ± 0.7	2.4 ± 0.4
t	15.202	14.788
P value	< 0.01	< 0.01

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Table 3 Comparison of short-term efficacy between the two groups, n (%)

Groups	3 months				6 months
Groups	CR	PR	SD	PD	CR	PR	SD	PD
Experimental group (n = 32)	18 (56.3)	9 (28.1)	3 (9.4)	2 (6.3)	21 (65.6)	8 (25.0)	2 (6.3)	1 (3.1)
Control group (n = 33)	8 (24.2)	12 (36.4)	8 (24.2)	5 (15.2)	12 (36.4)	11 (33.3)	6 (18.2)	4 (12.1)
χ²	4.584		4.584		4.447		4.447
P value	< 0.05		< 0.05		< 0.05		< 0.05

CR: Complete remission; PR: Partial remission; SD: Stable disease; PD: Progressive disease.

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Table 4 Comparison of acute adverse reactions between the two groups, n (%)

Group	Acute esophagitis		Acute pneumonia		Skin reactions
Group	Grade 1-2	Grade 3-4	Grade 1-2	Grade 3-4	Grade 1-2	Grade 3-4
Experimental group (n = 32)	9 (31.3)	2 (6.3)	7 (21.9)	1 (3.1)	8 (25.0)	1 (3.1)
Control group (n = 33)	18 (54.5)	5 (15.2)	15 (45.5)	4 (12.1)	14 (42.4)	4 (12.1)
χ²	8.125		7.099		4.670
P value	< 0.05		< 0.05		< 0.05

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Table 5 Comparison of late adverse reactions between the two groups, n (%)

Group	Fibrosis		Stenosis		Cardiac injury
Group	Grade 1-2	Grade 3-4	Grade 1-2	Grade 3-4	Grade 1-2	Grade 3-4
Experimental group (n = 32)	6 (18.8)	1 (3.1)	5 (15.6)	1 (3.1)	4 (12.5)	0 (0.0)
Control group (n = 33)	12 (36.4)	4 (12.1)	11 (33.3)	3 (9.1)	9 (27.3)	3 (9.1)
χ²	5.031		4.275		4.986
P value	< 0.05		< 0.05		< 0.05

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Citation: Gou CX, Zheng AM, Song HX, Gou QY, Tao N. Multimodal image-guided volumetric modulated arc radiotherapy for postoperative esophageal cancer: A prospective randomized controlled trial. World J Gastrointest Surg 2026; 18(10): 123247
URL: https://www.wjgnet.com/1948-9366/full/v18/i10/123247.htm
DOI: https://dx.doi.org/10.4240/wjgs.123247

Gou CX, Zheng AM, Song HX, Gou QY, Tao N. Multimodal image-guided volumetric modulated arc radiotherapy for postoperative esophageal cancer: A prospective randomized controlled trial. World J Gastrointest Surg 2026; 18(10): 123247 [DOI: 10.4240/wjgs.123247]

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