Long-term results of definitive radiotherapy for stage I esophageal cancer.
OBJECTIVE
To analyze retrospectively the long-term results of external beam radiotherapy (RT) with or without intraluminal brachytherapy (ILBT) for patients with Stage I esophageal cancer.


METHODS
A total of 34 patients with esophageal squamous cell carcinoma, clinically diagnosed as having Stage I disease, were treated with definitive RT, with or without ILBT. The median age was 69 years. Seven patients were treated with external beam RT alone (median, 64 Gy), and 27 were treated with external beam RT (median, 52 Gy) plus ILBT (8-12 Gy in two to three fractions).


RESULTS
The 5-year overall survival, local relapse-free survival, and cause-specific survival rate was 58.9%, 68.4%, and 80.0%, respectively, with a median follow-up of 61 months. Of 9 patients with local recurrence after initial therapy, 7 were successfully treated, and the 5-year cumulative rate of esophagectomy was 19.6%. The 2-year local relapse-free rate for patients with and without ILBT was 79.1% and 53.6%, respectively.


CONCLUSIONS
Although local recurrence was frequent within 2 years, the disease-specific survival rate was high owing to effective salvage therapy. Definitive RT is a reasonable treatment option for highly comorbid and elderly patients with Stage I esophageal cancer. The role of ILBT needs to be clarified.
Sai
Heitetsu
H
Department of Therapeutic Radiology and Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan. hsai@kuhp.kyoto.ac.jp
Mitsumori
Michihide
M
Araki
Norio
N
Mizowaki
Takashi
T
Nagata
Yasushi
Y
Nishimura
Yasumasa
Y
Hiraoka
Masahiro
M
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate