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

Katano,Atsuto; Yamashita,Hideomi; Nakagawa,Keiichi

doi:10.3892/mco.2017.1384

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

Authors:
- Atsuto Katano
- Hideomi Yamashita
- Keiichi Nakagawa
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Affiliations: Department of Radiology, University of Tokyo Hospital, Tokyo 113‑8655, Japan
Published online on: August 18, 2017 https://doi.org/10.3892/mco.2017.1384
Pages: 681-686

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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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