title: Feasibility of salvage endoscopic resection for patients with locoregional failure after definitive radiotherapy for pharyngeal cancer.
abstract: OBJECTIVE
  Local failure after radiation therapy for pharyngeal squamous cell carcinoma (PSCC) is problematic. The safety of endoscopic resection for lesions within the radiation therapy (RT) field has not been assessed. We evaluated salvage endoscopic resection in patients with locoregional failure after definitive radiotherapy for PSCC.
  
  
  METHODS
  We retrospectively evaluated the clinical outcomes and long-term survival of 16 patients initially treated with more than 60 Gy of radiation for PSCC. These patients later presented with 19 superficial metachronous or recurrent PSCC lesions within the radiation field and were treated with salvage endoscopic resection.
  
  
  RESULTS
  Local recurrence developed at the primary site in 3 patients after a complete response to RT. The other 13 had multiple metachronous squamous cell carcinomas within the original RT field. Major complications associated with salvage endoscopic resection included aspiration pneumonia in 1 patient and a requirement for temporary tracheostomy in 3 patients. During a median follow-up period of 37 months (range, 2 - 72 months), 13 patients had no recurrence, 2 patients developed local recurrence, and 1 patient developed lymph node metastases. At present, 5 of the 16 patients have died: 2 of PSCC progression, 1 of esophageal squamous cell carcinoma, and the remaining 2 of unknown causes. The 3-year survival rate was 68.6 %.
  
  
  CONCLUSIONS
  Endoscopic resection is a potentially curative salvage treatment option for patients with superficial locoregional failure after definitive radiotherapy for PSCC.
authors.affiliation: Department of Gastroenterology Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Hironaga
authors.initials: H
authors.lastname: Satake
authors.affiliation: Department of Gastroenterology Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yano
authors.affiliation: Department of Gastroenterology Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yoda
authors.affiliation: Pathology Division, Research Center for Innovative Oncology, National Cancer Center, Kashiwa, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fujii
authors.affiliation: Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Sadatomo
authors.initials: S
authors.lastname: Zenda
authors.affiliation: Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tomioka
authors.affiliation: Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shinozaki
authors.affiliation: Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyazaki
authors.affiliation: Department of Gastroenterology Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kaneko
authors.affiliation: Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi