Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy.
OBJECTIVE
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.


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).


CONCLUSIONS
Re-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.
Department of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea.
Young Suk
YS
Kim
Chang Geol
CG
Lee
Kyung Hwan
KH
Kim
Taehyung
T
Kim
Joohwan
J
Lee
Yona
Y
Cho
Woong Sub
WS
Koom
Chemotherapy; Esophageal cancer; Neoplasm recurrence; Radiotherapy; Re-irradiation; Toxicity