Abstract
PurposeThe aim of this study was to evaluate the salvage radiotherapy outcome in patients with local recurrent esophageal cancer after radical radiochemotherapy (RCT).MethodsA total of 114 patients with local recurrent esophageal squamous cell carcinoma after initial radical RCT were retrospectively analyzed. Fifty-five (55) patients belonged to the salvage radiotherapy group (SR group) and 59 patients to the non-salvage radiotherapy group (NSR group).ResultsThe median survival time after-recurrence was 4 months in all patients. The 1, 2, 3 year overall survival (OS) rates were 83.6%, 41.8% and 21.8% respectively in the SR group, and 57.6%, 16.9%, and 8.5% in the NSR group. The 6-month and 1-year survival rates after-recurrence were 41.8% and 16.4% respectively in the SR group, and 11.9% and 3.4% respectively in the NSR group. A salvage radiation dose > 50 Gy after initial radical RCT, improved the survival of patients with local recurrent esophageal cancer. Three patients (5.45%) from the SR group showed more than 3-grade radiation pneumonitis. In addition, esophageal fistula/perforation was observed in 11 cases (20.0%) in the SR group and in 8 cases (13.6%) in the NSR group.ConclusionsSalvage treatment after definitive RCT may improve the overall survival and survival after-recurrence of patients with local recurrent esophageal cancer.
Highlights
Loco-regional recurrence is still the major type of treatment failure in patients with esophageal cancer after definitive radiotherapy (RT) or radiochemotherapy (RCT)
General clinical data Hundred fourteen (114) patients with local recurrent esophageal cancer after radical RCT were retrospectively analyzed from December 2003 to January 2012
The following criteria were used to recruit the patients: 1) patients with esophageal cancer who had received definitive RCT treatment; 2) patients with pathologically confirmed squamous cell carcinoma; 3) patients with local recurrence confirmed by pathological analysis, without simultaneous local regional lymph nodes recurrence or distant recurrence; 4) patients with no salvage esophagectomy treatment after recurrence; 5) patients without any other serious medical illness except esophageal cancer
Summary
Loco-regional recurrence is still the major type of treatment failure in patients with esophageal cancer after definitive radiotherapy (RT) or radiochemotherapy (RCT). The recurrence rate after radical radiotherapy, radiochemotherapy and surgery is more than 70% [1,2]. The 5-year survival rate became worse [3,4]. Treatments such as salvage surgery, radiotherapy/ radiochemotherapy and chemotherapy are usually carried out on patients with recurrent esophageal cancer. These treatments on recurrent esophageal cancer (REC) report similar unsatisfactory results with regard to survival [4,5,6].
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