Cho Won Kyung, Noh Jae Myoung, Oh Dongryul, Ahn Yong Chan, Sun Jong-Mu, Kim Hong Kwan, Shim Young Mog
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2025 Jan;57(1):165-173. doi: 10.4143/crt.2024.191. Epub 2024 Jul 26.
There is few evidence regarding the optimal salvage treatment options for loco-reginal recurrence of esophageal cancer. This study aimed to evaluate the clinical outcomes of salvage radiotherapy (RT) in patients with loco-regional recurrence (LRR) after surgery for esophageal cancer.
We retrospectively reviewed 147 esophageal cancer patients who received salvage RT for loco-regional recurrence between 1996 and December 2019. A total dose of 60 Gy in 20 fractions was used for RT alone and 60-70 Gy in 30-35 fractions for concurrent chemoradiotherapy (CCRT).
The patients' median age was 65 years (range, 41 to 86 years). The median disease-free interval was 13.5 months (1.0 to 97.4 months). After a median 18.8 months follow-up, the 2-year overall survival (OS) and progression-free survival (PFS) rates were 38.1% and 25.9%, respectively. The median OS and PFS were 18.8 and 8.4 months, respectively. The CCRT could not improve OS compared to RT (p=0.336), but there was a trend of better PFS in the CCRT group. Regarding toxicities, the rate of grade 3 or higher toxicity was 10.9% occurring in 16 patients, and it was higher in patients who received CCRT than in the RT alone group (19.6% vs. 6.3%, p=0.023).
Salvage RT alone as well as CCRT could be effective in patients with locoregionally recurrent esophageal cancer.
关于食管癌局部区域复发的最佳挽救治疗方案，几乎没有相关证据。本研究旨在评估食管癌手术后局部区域复发（LRR）患者接受挽救性放疗（RT）的临床结局。
我们回顾性分析了1996年至2019年12月间147例因局部区域复发接受挽救性放疗的食管癌患者。单纯放疗总剂量为60 Gy，分20次给予；同步放化疗（CCRT）总剂量为60 - 70 Gy，分30 - 35次给予。
患者的中位年龄为65岁（范围41至86岁）。中位无病间期为13.5个月（1.0至97.4个月）。中位随访18.8个月后，2年总生存（OS）率和无进展生存（PFS）率分别为38.1%和25.9%。中位OS和PFS分别为18.8个月和8.4个月。与单纯放疗相比，同步放化疗未能改善总生存（p = 0.336），但同步放化疗组的无进展生存有更好的趋势。关于毒性反应，16例患者发生3级或更高毒性反应的发生率为10.9%，接受同步放化疗的患者高于单纯放疗组（19.6%对6.3%，p = 0.023）。
单纯挽救性放疗以及同步放化疗对局部区域复发的食管癌患者可能有效。
