title: Chemical ablation therapy of recurrent mediastinal nodal metastasis in post-radiotherapy cancer patients.
abstract: The aim of our study was to evaluate the treatment of post-radiotherapy recurrent mediastinal nodal metastasis. Post-radiotherapy esophageal cancer patients with mediastinal lymph node recurrence were enrolled in this study. Patients were randomized into the radiation (±chemotherapy) or the chemoablation group. Patients randomized to the chemoradiotherapy group received additional radiotherapy, second-line chemotherapy, or both. Patients randomized to the chemoablation group received CT-guided percutaneous chemical ablation. Clinical remission was assessed at 1 month by contrast CT. Reirradiation dose ranged from 2,200 to 3,600 cGy depending on dose-limiting constraints in consideration of prior radiotherapy dose. The RECIST criteria were used in the evaluation of response to therapy. The median length of follow-up is 6 months. Thirty-one patients were enrolled in the study. In the chemoradiation group, all patients underwent CT imaging at 1-month follow-up. Among these patients, seven had progressive disease, five had stable disease (SD), and four had partial response (PR). The 6-month survival rate was 12.5%. In the chemoablation group at 1-month follow-up, 12 patients had SD and three patients had PR, and the 6-month survival rate was 46.6%. Our results suggest that chemoablation therapy as salvage treatment after post-radiotherapy relapse is efficacious and safe.
authors.affiliation: Department of Oncology, Pingyi Branch of Qilu Hospital, Shandong University, Linyi, Shandong, China, xlk2002@126.com.
authors.forename: Xinglu
authors.initials: X
authors.lastname: Xu
authors.forename: Xiuling
authors.initials: X
authors.lastname: Li
authors.forename: Xin
authors.initials: X
authors.lastname: Ye
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Peng
authors.forename: Tian
authors.initials: T
authors.lastname: Liang
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Hao
mesh_terms: D017115:Catheter Ablation / Q000379:methods; D059186:Chemoradiotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008207:Lymphatic Metastasis; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D061089:Radiotherapy, Image-Guided; D015996:Survival Rate; D014057:Tomography, X-Ray Computed