Radiation therapy for loco-regionally recurrent esophageal cancer after surgery

Salvage radiotherapy in patients with recurrent esophageal carcinoma

“…Improvement of symptoms with an objective response rate of 65-91% has been reported in several studies [5,15,16]. In our study, an objective improvement of symptoms was observed in 68% of patients, which is in line with other reports.…”

“…According to Nemoto et al [16], the time interval between surgery and the onset of locoregional recurrence (the cut off was 8 months) was the only significant prognostic factor selected by both univariate and multivariate analysis. In our study, patients with recurrence in the same time interval (<8 months) had a poorer OS, although statistically not significant (.…”

“…In a randomized study of adjuvant postoperative RT after curative resection of esophageal cancer [18], postoperative RT significantly increased the incidence of fibrotic strictures of the esophago-gastric or esophagocolonic anastomoses, although no increase in ulcers or fistulae was reported. Nemoto et al [16] reported that 1 patient (3%) died of necrosis of the gastric tube 6 months after an RT dose of 66 Gy. Shioyama et al [5] observed no significantly survival difference between the REC patients treated with 60 Gy or more and those treated with less than 60 Gy (p = 0.10), but a significant difference between doses <50 Gy and ≥ 50 Gy (p = 0.04).…”

“…For example, Baxi et al [19] report that patients <60 years old have a better outcome, whereas Nemoto et al [16] and Jingu et al [14] report a better outcome in patients >62 years. In definitive RT for esophageal cancer, a combination with chemotherapy seems to be effective [9], but the advantage of simultaneous chemotherapy in the treatment of REC needs to be investigated.…”

“…Although the effectiveness of concurrent radiochemotherapy for the primary treatment of esophageal carcinoma has been adequately demonstrated [2,9,10,11,12], only a few studies have addressed the feasibility and effectiveness of concurrent radiochemotherapy for REC [14,15,16]. Thus, the purpose of this study was to evaluate the treatment outcome after radio(chemo)therapy in the management of REC.…”