Hulshof MCCM, Geijsen ED, Rozema T, et al. - Researchers investigated the impact of radiation dose escalation to the primary tumor on local tumor control in definitive chemoradiation (dCRT) for patients suffering from esophageal cancer. Participants were patients having medically inoperable and/or irresectable esophageal carcinoma, referred for dCRT. These were randomized between a standard dose (SD) of 50.4 Gy/1.8 Gy for 5.5 weeks to the tumor and regional lymph nodes and a high dose (HD) up to a total dose of 61.6 Gy to the primary tumor. Chemotherapy comprised courses of concurrent carboplatin (area under the curve 2) and paclitaxel (50 mg/m ² ) in both arms once a week for 6 weeks. The 3-year local progression-free survival was estimated to be 70% in the SD arm vs 73% in the HD arm (not significant). For SD and HD arms, 3-year locoregional progression-free survival was estimated to be 52% and 59%, respectively. Overall, no significant increase in local control over 50.4 Gy was conferred by radiation dose escalation up to 61.6 Gy to the primary tumor in dCRT for esophageal cancer. In both adenocarcinoma and squamous cell carcinoma, no dose effect was seen.