Kim Young Suk, Lee Chang Geol, Kim Kyung Hwan, Kim Taehyung, Lee Joohwan, Cho Yona, Koom Woong Sub
Department of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea.
Radiat Oncol J. 2012 Dec;30(4):182-8. doi: 10.3857/roj.2012.30.4.182. Epub 2012 Dec 31.
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.
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).
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).
Re-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.
对于接受过初次根治性放疗后的复发性食管癌，目前尚无通用的治疗指南。我们评估了复发性食管癌再程放疗（re-RT）的毒性和临床结局。
我们分析了10例在初次根治性放疗后接受再程放疗的复发性食管癌患者。初次放疗与再程放疗之间的中位时间间隔为15.6个月（范围4.8至36.4个月）。初次放疗的总剂量中位值为50.4 Gy（范围50.4至63.0 Gy）。再程放疗的总剂量中位值为46.5 Gy（范围44.0至50.4 Gy）。
中位随访期为4.9个月（范围2.6至11.4个月）。再程放疗结束后3个月时的肿瘤反应为完全缓解（n = 2）、部分缓解（n = 1）、疾病稳定（n = 2）和疾病进展（n = 5）。3例患者发生5级气管食管瘘。这3例患者中有2例初次放疗与再程放疗之间的时间间隔小于12个月。晚期毒性包括1级吞咽困难（n = 1）。
初次放疗后的复发性食管癌再程放疗可导致严重毒性。
