Salvage radiotherapy in patients with local recurrent esophageal cancer after radical radiochemotherapy

Zhou, Zhiguo; Zhen, Chanjun; Bai, Weibin; Ping, Zhang; Qiao, Xueying; Liang, Jia; Gao, Xianshu; Wang, Shuoshuo

doi:10.1186/s13014-015-0358-z

Cited by 42 publications

(62 citation statements)

References 24 publications

(36 reference statements)

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“…This study is believed to be the rst to compare the effects of 50 Gy and 60 Gy re-irradiation dose on the survival of patients with LRESCC with radiation history. Our results showed that most patients (68/125, 54.4%) had recurrence within 2 years after initial (chemo)radiotherapy, which was consistent with previous reports [4,8,13,16]. Jingu et al reported that the 3-year survival rate and median survival time of 33 patients with LRESCC receiving 60 Gy (range, 18-70 Gy) re-radiotherapy were 17.8% and 16 months, respectively [15].…”

Section: Discussionsupporting

confidence: 91%

“…Increasing the dose of radiation showed an encouraging outcome. Our results are also better compared with those of other studies [4,13,15]. The reason may be that higher doses of radiation were more bene cial for tumor control.…”

Section: Discussionsupporting

confidence: 45%

“…Recently, a study of the effect of dose-escalated radiotherapy on ESCC showed that, in patients who achieved complete response, radiotherapy dose was increased to > 59.4 Gy after standard concurrent chemoradiotherapy (50.4 Gy), which signi cantly improved local control, 5-year recurrence-free survival rate and 5-year OS rate [12]. Previously, some studies have indicated that the survival rate of LRESCC can be signi cantly prolonged when the dose of re-irradiation is > 50 Gy [4,13]. Kobayashi et al pointed out that 60 Gy was an appropriate salvage dose for LRESCC after surgery [14].…”

Section: Discussionmentioning

confidence: 99%

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Increased dose of re-irradiation therapy or combined chemotherapy to improve survival of local recurrent esophageal squamous cell carcinoma after radiotherapy

Chen

et al. 2020

Preprint

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Introduction: This study aimed to explore the optimal treatment for locally recurrent esophageal squamous cell carcinoma (LRESCC) by analyzing the results of different doses of re-irradiation therapy after radical (chemo) radiotherapy. Methods: We retrospectively analyzed 125 patients with LRESCC after initial radiotherapy. According to radiotherapy dose, 58 patients were assigned to the low-dose (LD) group (50–54 Gy) and 67 to the high-dose (HD) group (55–60 Gy). We recorded the response rate (complete + partial response), 1-, 2- and 3-year survival rates, and toxicity in the two groups. The effects of different radiotherapy doses and combination chemotherapy on the survival of LRESCC were analyzed. Results: After re-irradiation, the 1-, 2- and 3-year survival rates were 48.3%, 24.1% and 10.3% in the LD group and 61.2%, 34.3% and 19.4% in the HD group (P<0.05), respectively. The median survival time of patients receiving radiotherapy alone was 9 months in the LD group and 15 months in the HD group (P<0.05). The survival rate of patients treated with chemoradiotherapy was higher than that of patients treated with radiotherapy alone in the LD group, but in the HD group, chemoradiotherapy showed no advantage compared with radiotherapy alone. The most common toxicity was esophagitis, and the incidence was higher in the HD group than in the LD group (68.7% vs 58.6%, P＜0.05). Conclusion: Increasing the dose of re-irradiation therapy or chemotherapy can improve the efficacy of re-irradiation therapy for patients with LRESCC after radiotherapy.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

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Increased dose of re-irradiation therapy or combined chemotherapy to improve survival of local recurrent esophageal squamous cell carcinoma after radiotherapy

Chen

et al. 2020

Preprint

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“…Esophageal cancer is the seventh most common cause of cancer-related mortality in Japan, with an estimated 11,746 deaths in 2008 (12). Re-irradiation salvage therapy, with or without chemotherapy, for recurrent esophageal carcinoma after definitive chemoradiotherapy yielded reasonable results in this small group of patients, extending MST from the expected 9.9 months (2) to 13.6 months.…”

Section: Discussionmentioning

confidence: 99%

Re-irradiation of locoregional esophageal cancer recurrence following definitive chemoradiotherapy: A report of 6 cases

Katano

Yamashita

Nakagawa

2017

Molecular and Clinical Oncology

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Abstract. There is currently no consensus on salvage therapy for recurrent esophageal cancer. Salvage surgery is a well-established option for attaining long-term survival; however, it is associated with a high risk of perioperative morbidity and mortality. A total of 6 patients who underwent re-irradiation for recurrence of locoregional esophageal cancer following definitive chemoradiotherapy were investigated. The median interval between initial radiotherapy and re-irradiation was 17.4 months (range, 6.4-59.2 months). Re-irradiation salvage therapy was mostly administered with concurrent chemotherapy, which consisted of several cycles of nedaplatin on day 1 and oral S-1 administration on days 1-14. The median survival after re-irradiation was 13.6 months (range, 1.9-33.3 months). A total of 3 patients who completed hyperfractionated radiation therapy survived for >1 year. One patient has had no signs of recurrence or late radiation toxicity for >2 years. Severe acute hematological adverse events (AEs) occurred in 3 patients, including 1 case of grade 4 leukopenia. One severe late AE occurred in 1 patient, who developed grade 3 dysphagia and became permanently dependent on percutaneous endoscopic gastrostomy tube feeding. Salvage radiotherapy is considered to be a good treatment option for inoperable locoregional recurrent esophageal cancer. The results of the present study demonstrated that re-irradiation, with or without chemotherapy, for recurrent esophageal carcinoma after definitive chemoradiotherapy was tolerable and yielded reasonably satisfactory results.

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“…Re-RT was a strong risk factor for EF (P=0.003, OR=3.926 ,95%CI: 1.615-9.548). Zhou et al [29] reported 55 patients with recurrent EC happened EF after re-RT. The study found that re-RT could improve survival rate of patients, but the incidence of EF was as high as 20% (11/55).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Esophageal Fistula after Radiotherapy for Esophageal Squamous Cell Carcinoma

Hu¹,

Feng²,

Zhou³

et al. 2020

J. Cancer

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Purpose: The aim of this study was to investigate risk factors for esophageal squamous cell carcinoma (ESCC) treated with radiotherapy (RT) with or without chemotherapy to guide how to reduce the occurrence of esophageal fistula (EF). Methods: 414 patients with ESCC who underwent RT with or without chemotherapy were collected in Shandong Cancer Hospital from February 2012 to June 2018 retrospectively. The clinical characters and dosimetric parameters were recorded. Univariate and multivariate logistic regression analyses were provided to determine the risk factors associated with EF. Results: The cumulative incidences of EF were 11.1% (46/414 patients). The median follow-up period was 15.8 months (range: 0.2-82.6months). The median survival time (MST) of patients with EF was 5.3 months. In univariate analysis, age, T4 stage, N3 stage, chemotherapy regimens, re-RT, ulcerative esophageal cancer (EC), esophageal stenosis, the maximum thickness of the tumor and the length of tumor had a correlation with the prevalence of EF. In multivariable logistic regression analysis, T4 stage, N3 stage, re-RT, ulcerative EC, esophageal stenosis, the maximum thickness of the tumor was confirmed as risk factors for EF. Conclusion: This study revealed that T4 stage, N3 stage, re-RT, ulcerative EC, esophageal stenosis, the maximum thickness of the tumor were risk factors associated with EF. We ought to attach importance to the prevention of EF. Patients with risk factors for EF should be paid close attention.

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Salvage radiotherapy in patients with local recurrent esophageal cancer after radical radiochemotherapy

Cited by 42 publications

References 24 publications

Increased dose of re-irradiation therapy or combined chemotherapy to improve survival of local recurrent esophageal squamous cell carcinoma after radiotherapy

Increased dose of re-irradiation therapy or combined chemotherapy to improve survival of local recurrent esophageal squamous cell carcinoma after radiotherapy

Re-irradiation of locoregional esophageal cancer recurrence following definitive chemoradiotherapy: A report of 6 cases

Risk Factors Associated with Esophageal Fistula after Radiotherapy for Esophageal Squamous Cell Carcinoma

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