Salvage Radiotherapy for Loco-regional Recurrence of Esophageal Cancer Following Surgery

• Published in: Cancer research and treatment 2025, 57(1), , pp.165-173
• Main Authors: Cho, Won Kyung, Noh, Jae Myoung, Oh, Dongryul, Ahn, Yong Chan, Sun, Jong-Mu, Kim, Hong Kwan, Shim, Young Mog
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Chemoradiotherapy - methods; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophageal Neoplasms - radiotherapy; Esophageal Neoplasms - therapy; Esophagectomy - methods; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - radiotherapy; Original; Retrospective Studies; Salvage Therapy - methods; 의학일반
• ISSN: 1598-2998; 2005-9256; 2005-9256
• DOI: 10.4143/crt.2024.191

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.