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Purpose E N JU J N N NL R NUb N N JUU R JU AD MR NJ N O NN

R JU 68D JWM aRLR b RW J RNW R U LJUUb JM JWLNMN JPNJU LJWLN 75 WMN NW WN JMS JWL NV JMR N J b 5CE O UU NM Kb N JPNL Vb

BJ RNW f L J JL N R RLNJW 3PN - bNJ JWPN ) ./

8 UU )( V W JWPN - -9NWMN )) VJUN JWM ONVJUN

:R U Pb 36 1 (02 D551 -

E V U LJ R W 97 1((2 U N N JP 1 /2 VRM N JP 1 -

LE D JPN E 1 ) 2 E)1 ,

L D JPN (1 (+2 )1 .2 1 +

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O N L N JWM JKM VNW JWM (/8 869 B7E E5%

Target volume delineation

GTV includes visible primary tumor and pathological nodes (5E LJW B7E 7WM L b JWM 7FD%

CTV: area of subclinical involvement around GTV , defined with a radial expansion of 1-1,5 cm, and 3-5 cm longitudinally, along the length of esophagus and cardia. Including Elective lymph node stations. PTV: CTV + isotropic expansion of 0,6 – 1 cm

PTV

GTV CTV PTV

Planning and Delivery

CE J MNUR N NM RWP RW NW R b V M UJ NM JMRJ R W N J b ; CE R MROON NW NL WR N 1

M 5 ; CE NL WR N O (, J RNW - :NURLJU E V N J b O ( J RNW +RWP ; 35 - 56 e ; 35 )( 56

E N N L RKNM M N J +, , %+ 9b JMVRWR N NM RW ), )/ MJRUb O JL R W (%/ 9b O JL R W ( M N N L RKNM J UNJ 0, BEG

Trimodality treatment Chemotherapy was administered concurrently using platinum based regimen in association with fluoropyrimidine or taxanes. g 5R UJ RW ., ( VP V) W MJb ( JWM )0 8U JLRU ., ( VP V) L W RW RWO R W

N )+ MJRUb W MJb ( + JWM )0 ) , e MJb LbLUN%g BJLUR JaNU , VP V) W MJb ( 5J K UJ RW 3F5) W MJb ( HNNTUb O , NNT % Esophagectomy was performed in 20 patients; in 5 cases surgery was excluded because of disease progression, worsening of clinical conditions or patient refusal.

; N R 7 JPNL Vb

1 – year DFS: 94.4% 3 – year DFS: 74.4%

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1 – year OS: 94.7% 3 – year OS: 63.3%

E N ORWJU JV UN RcN RWLU MNM ) J RNW L V UN NM RV MJUR b NJ VNW

Clinical response (cR) to NCRT was evaluated with esophagoscopy, CECT, EUS and

PET, if necessary, before surgery, comparing pre-NCRT data with those obtained post-

NCRT.

Partial or complete clinical response(cR) was achieved in 16 patients (80%).

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Pathologic response (pR) evaluation was performed by analyzing surgical specimens

and was achieved in 15 patients (75%). In particular pathological complete response

was obtained in 3 of them (15%).

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! 1 patient (5%) experienced loco-regional failure and synchronous

distant metastases.

! 3 patients (15%) developed distant metastases

4 patients died (20%): 3 from esophageal cancer (15%) and 1 from

hematological toxicity related to chemotherapy (5%).

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