{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T02:56:18Z","timestamp":1789872978600,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2023YFQ0055"],"award-info":[{"award-number":["2023YFQ0055"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2023YFS0488"],"award-info":[{"award-number":["2023YFS0488"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2020YFH0169"],"award-info":[{"award-number":["2020YFH0169"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["8257102746"],"award-info":[{"award-number":["8257102746"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The method of lymph node (LN) irradiation for locally advanced esophageal squamous cell carcinoma (LA\u2010ESCC) is still a topic of debate. We investigated the efficacy, toxicity, and rate of out\u2010of\u2010field LNs in irradiation across different target areas in patients with LA\u2010ESCC undergoing neoadjuvant chemoradiotherapy (nCRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed patient records from June 2017 to August 2022 and divided patients into elective nodal irradiation (ENI) and involved\u2010field irradiation (IFI) groups. The differences in hematological and non\u2010hematological toxicities of the out\u2010of\u2010field LNs were analyzed between the two groups. The log\u2010rank test was used to evaluate the Kaplan\u2013Meier curves for overall and progression\u2010free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 306 included patients, 202 (66.0%) received ENI and 104 (34.0%) received IFI. At the 3\u2010year follow\u2010up, the survival rate did not differ significantly between the groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Although the occurrence of radiation\u2010induced pneumonia did not differ (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05), the incidence of radiation\u2010induced esophagitis and the degree of leukopenia differed significantly (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). While the average heart irradiation dose or heart V\n                      <jats:sub>20<\/jats:sub>\n                      , V\n                      <jats:sub>30<\/jats:sub>\n                      , and V\n                      <jats:sub>40<\/jats:sub>\n                      did not differ significantly (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05), we observed significant differences in the clinical target volume, average lung irradiation dose, and lung V\n                      <jats:sub>20<\/jats:sub>\n                      , V\n                      <jats:sub>30<\/jats:sub>\n                      , and V\n                      <jats:sub>40<\/jats:sub>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Among all patients, 29 cases (9.5%) experienced out\u2010of\u2010field LNs with 26 (93.1%) in abdominal LNs, whereas only 3 cases (6.9%) with out\u2010of\u2010field LNs were in the upper esophagus. There was no statistical significance between out\u2010of\u2010field LNs and LN irradiation methods (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.724).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Under similar prognostic conditions, IFI resulted in mild toxicity compared to ENI. Therefore, for patients with ESCC undergoing nCRT, IFI is the preferred irradiation approach for the lymphatic drainage area.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71392","type":"journal-article","created":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T13:45:45Z","timestamp":1764510345000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Involved\u2010Field Irradiation Versus Elective Nodal Irradiation in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma Treated With Neoadjuvant Chemoradiotherapy"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9082-3087","authenticated-orcid":false,"given":"Xiaoding","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingqiu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3262-5254","authenticated-orcid":false,"given":"Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiyu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongtao","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefeng","family":"Leng","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Cancer Hospital &amp; 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