Salvage radiation therapy for residual superficial esophageal cancer after endoscopic mucosal resection.
OBJECTIVE
To analyze the outcomes of radiation therapy for patients with residual superficial esophageal cancer (rSEC) after endoscopic mucosal resection (EMR).


METHODS
From May 1996 to October 2002, a total of 30 rSEC patients without lymph node metastasis received radiation therapy at Tohoku University Hospital and associated hospitals. The time interval from EMR to start of radiation therapy ranged from 9 to 73 days (median interval, 40 days). Radiation doses ranged from 60 Gy to 70 Gy (mean dose, 66 Gy). Chemotherapy was used in 9 of 30 patients (30%).


RESULTS
The 2-year, 3-year, and 5-year overall survival rates and cause-specific survival rates were 91%, 82%, and 51%, respectively, and 95%, 85%, and 73%, respectively. The 2-year, 3-year, and 5-year local control rates for mucosal cancer were 91%, 91%, and 91%, respectively, and those for submucosal cancer were 89%, 89%, and 47%, respectively. These differences in survival rates for patients with two types of cancer were not statistically significant. Local recurrence and lymph node recurrence were more frequent in patients with submucosal cancer than in patients with mucosal cancer (p = 0.38 and p = 0.08, respectively). Esophageal stenosis that required balloon dilatation developed in 3 of the 30 patients, and radiation pneumonitis that required steroid therapy developed in 1 patient.


CONCLUSIONS
Radiation therapy is useful for preventing local recurrence after incomplete EMR.
Nemoto
Kenji
K
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Aobaku, Sendai, Japan. knemoto@rad.med.tohoku.ac.jp
Takai
Kenji
K
Ogawa
Yoshihiro
Y
Sakayauchi
Toru
T
Sugawara
Toshiyuki
T
Jingu
Ken-Ichi
K
Wada
Hitoshi
H
Takai
Yoshihiro
Y
Yamada
Shogo
S
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D011379:Prognosis; D016879:Salvage Therapy