Radiat Oncol J.  2012 Dec;30(4):182-188.

Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy

• Kim YS
• Lee CG
• Kim KH
• Kim T
• Lee J
• Cho Y
• Koom WS

Abstract

PURPOSE
For recurrent esophageal cancer after primary definitive radiotherapy, no general treatment guidelines are available. We evaluated the toxicities and clinical outcomes of re-irradiation (re-RT) for recurrent esophageal cancer.
MATERIALS AND METHODS
We analyzed 10 patients with recurrent esophageal cancer treated with re-RT after primary definitive radiotherapy. The median time interval between primary radiotherapy and re-RT was 15.6 months (range, 4.8 to 36.4 months). The total dose of primary radiotherapy was a median of 50.4 Gy (range, 50.4 to 63.0 Gy). The total dose of re-RT was a median of 46.5 Gy (range, 44.0 to 50.4 Gy).
RESULTS
The median follow-up period was 4.9 months (range, 2.6 to 11.4 months). The tumor response at 3 months after the end of re-RT was complete response (n = 2), partial response (n = 1), stable disease (n = 2), and progressive disease (n = 5). Grade 5 tracheoesophageal fistula developed in three patients. The time interval between primary radiotherapy and re-RT was less than 12 months in two of these three patients. Late toxicities included grade 1 dysphagia (n = 1).
CONCLUSION
Re-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.

Keyword

Esophageal cancer; Neoplasm recurrence; Re-irradiation; Radiotherapy; Chemotherapy; Toxicity

MeSH Terms

Deglutition Disorders
Esophageal Neoplasms
Follow-Up Studies
Humans
Tracheoesophageal Fistula