Local field radiotherapy without elective nodal irradiation for postoperative loco-regional recurrence of esophageal cancer

Jpn J Clin Oncol. 2017 Sep 1;47(9):809-814. doi: 10.1093/jjco/hyx092.

Abstract

Background: Radiotherapy is an effective treatment for the postoperative loco-regional recurrence of esophageal cancer; however, the optimal treatment field remains controversial. This study aims to evaluate the outcome of local field radiotherapy without elective nodal irradiation for postoperative loco-regional recurrence of esophageal cancer.

Methods: We retrospectively investigated 35 patients treated for a postoperative loco-regional recurrence of esophageal cancer with local field radiotherapy between December 2008 and March 2016. The median irradiation dose was 60 Gy (range: 50-67.5 Gy). Thirty-one (88.6%) patients received concurrent chemotherapy.

Results: The median follow-up period was 18 months (range: 5-94 months). The 2-year overall survival was 55.7%, with a median survival time of 29.9 months. In the univariate analysis, the maximal diameter ≤20 mm (P = 0.0383), solitary lesion (P = 0.0352), and the complete remission after treatment (P = 0.00411) had a significantly better prognosis. A total of 27 of 35 patients (77.1%) had progressive disease (loco-regional failure [n = 9], distant metastasis [n = 7], and both loco-regional failure and distant metastasis [n = 11]). No patients had Grade 3 or greater mucositis.

Conclusion: Local field radiotherapy is a considerable treatment option for postoperative loco-regional recurrence of esophageal cancer.

Keywords: esophageal cancer; loco-regional recurrence; postoperative recurrence; radiotherapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / radiotherapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / radiotherapy*
  • Prognosis
  • Radiotherapy Dosage
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome