Cancer Res Treat.  2025 Jan;57(1):165-173. 10.4143/crt.2024.191.

Salvage Radiotherapy for Loco-regional Recurrence of Esophageal Cancer Following Surgery

• Cho WK
• Noh JM
• Oh D
• Ahn YC
• Sun JM
• Kim HK
• Shim YM

• KMID: 2564591
• DOI: http://doi.org/10.4143/crt.2024.191

Abstract

Purpose
There is few evidence regarding the optimal salvage treatment options for loco-reginal recurrence of esophageal cancer. This study aimed to evaluate the clinical outcomes of salvage radiotherapy (RT) in patients with loco-regional recurrence (LRR) after surgery for esophageal cancer.
Materials and Methods
We retrospectively reviewed 147 esophageal cancer patients who received salvage RT for loco-regional recurrence between 1996 and December 2019. A total dose of 60 Gy in 20 fractions was used for RT alone and 60-70 Gy in 30-35 fractions for concurrent chemoradiotherapy (CCRT).
Results
The patients’ median age was 65 years (range, 41 to 86 years). The median disease-free interval was 13.5 months (1.0 to 97.4 months). After a median 18.8 months follow-up, the 2-year overall survival (OS) and progression-free survival (PFS) rates were 38.1% and 25.9%, respectively. The median OS and PFS were 18.8 and 8.4 months, respectively. The CCRT could not improve OS compared to RT (p=0.336), but there was a trend of better PFS in the CCRT group. Regarding toxicities, the rate of grade 3 or higher toxicity was 10.9% occurring in 16 patients, and it was higher in patients who received CCRT than in the RT alone group (19.6% vs. 6.3%, p=0.023).
Conclusion
Salvage RT alone as well as CCRT could be effective in patients with locoregionally recurrent esophageal cancer.

Keyword

Esophageal neoplasms; Loco-regional recurrence; Salvage radiotherapy

Figure

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  Fig. 1. Kaplan-Meier curves of overall survival (A) and progression-free survival rates (B) and patterns of failures following salvage radiotherapy for locoregionally recurrent esophageal cancer (C).

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