THE CLINICAL BENEFIT OF CHEMORADIOTHERAPY FOR RECURRENT ESOPHAGEAL CANCER

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Abstract

Objective

The standard therapy for recurrent esophageal cancer is systemic chemotherapy. However, in cases in which the recurrent lesion is confined to the area where radiotherapy is applied, chemoradiotherapy will be able to provide better local control and prognosis.

Method

A retrospective study was carried out on 14 patients with local recurrent esophageal cancer but no other metastasis who underwent chemoradiotherapy (FP-RT: 5FU 700 mg/m2 on days 1–4, CDDP 70 mg/m2 on day 1, 4 weeks for one course × 2, RT: 60–66 Gy/30–33 Fr) at Toyama Prefectural Central Hospital between April 2008 and February 2012.

Result

The subjects included 13 men and 1 woman. The median age was 64 years (PS0/1/2 = 3/9/2). The histology was classified into squamous cell carcinoma in 13 subjects and carcinosarcoma in one subject. The site of the radiation therapy was recurrence in the lymph nodes in 10 patients, anastomotic recurrence in 3 patients and recurrence in pleural nodes in 1 patient. Regarding the tumor reduction effect, the lesions of 12 patients were evaluable by RECIST, and the response rate was 66.6%. The median of progression-free survival (PFS) was 251 days (8.4 months) and the median of overall survival was 475 days (15.8 months). Exacerbation of the irradiated lesions was observed in four patients (31%), whereas new lesions at other sites were observed in seven patients (55%). G3 or more adverse events were hematologic toxicity (23%) and non-hematologic toxicity (23%), such as anorexia and nausea.

Discussion and conclusion

This study showed that chemoradiotherapy for local recurrent esophageal cancer provides the excellent local control. The severity of adverse reactions caused by the therapy was relatively mild, and OS was good. In the future, the relationship between transient local control and survival time should be studied in a prospective setting.

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