Whole neck 66Gy by dose painting

This case was  treated the cancer of thoracic esophagus by surgical resection previously.  But recurrent mass was found at the anastomosis site. And another cancer was found at right tonsil and tongue with multiple lymphnode metastasis at bilateral neck.

I recommended dose limit as 60Gy for whole neck irradiation due to sever side effects, but others advocated more high dose for tumor control. After all, it was decided that this case should be treated by prescribed dose 66Gy with oral S-1 concurrently.

I use °∆whole neck template with CFIMRT°« to make treatment plan, but several modification was made such as dose weight, field cut (because I afraid to make stenosis or perforation at anastomosis site).

 

 This case achieved complete response.

17month after

  last modification date: 2011/1/11