Abstract
We aimed to evaluate the application of external beam radiotherapy (EBRT) combined with californium-252 (252Cf) neutron intraluminal brachytherapy (NBT) in patients with local recurrent esophageal cancer after definitive chemoradiotherapy (CRT). Sixty-two patients with local recurrent esophageal squamous cell carcinoma after definitive CRT were retrospectively analyzed; 31 patients underwent NBT+EBRT, and 31 received EBRT alone. The response rate; 1-, 2-, and 3-year overall survival rates; and adverse event occurrence rates were compared between these two patient groups. The response rate was 83.87% (26/31) in the NBT+EBRT group and 67.74% (21/31) in the EBRT group (p < 0.001). The 1-, 2-, and 3-year overall survival rates were 80.6%, 32.3%, and 6.5%, respectively, in the EBRT group, with a median survival time of 18 months. The 1-, 2-, and 3-year overall survival rates were 83.8%, 41.9%, and 6.9%, respectively, in the NBT+EBRT group, with a median survival time of 19 months. The differences between the groups were not significant (p = 0.352). Regarding acute toxicity, no incidences of fistula or massive bleeding were observed during the treatment period. The incidences of severe and late complications were not significantly different between the two groups (p = 0.080). However, the causes of death for all patients differed between the groups. Our data indicate that 252Cf-NBT+EBRT produces favorable local control for patients with local recurrent esophageal cancer after CRT, with tolerable side effects.
Highlights
In 2014, approximately 200,000 new patients in China were diagnosed with local recurrent esophageal c ancer[1], and the prevalence of this disease is expected to be younger and increase
The prescription dose to reirradiate a target is limited by dose constraints of the surrounding normal tissue, and the local recurrence of esophageal carcinoma after definitive RT or chemoradiotherapy (CRT) is resistant to conventional photon radiotherapy
Brachytherapy is appropriate for the local recurrence of esophageal cancer after RT/CRT due to the high doses of radiation to the tumor and the low doses to nearby normal tissues[7]
Summary
In 2014, approximately 200,000 new patients in China were diagnosed with local recurrent esophageal c ancer[1], and the prevalence of this disease is expected to be younger and increase. The prescription dose to reirradiate a target is limited by dose constraints of the surrounding normal tissue, and the local recurrence of esophageal carcinoma after definitive RT or chemoradiotherapy (CRT) is resistant to conventional photon radiotherapy. Brachytherapy is appropriate for the local recurrence of esophageal cancer after RT/CRT due to the high doses of radiation to the tumor and the low doses to nearby normal tissues[7]. No multicenter, randomized prospective trials have compared the efficacy of NBT+EBRT and EBRT for the treatment of esophageal carcinoma and recurrence after definitive CRT. We conducted a retrospective study to evaluate the morbidity and effectiveness of EBRT combined with 252Cf-NBT in treating patients with local recurrent esophageal carcinoma after definitive CRT
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