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Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy

  • Kim, Young Suk (Department of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine) ;
  • Lee, Chang Geol (Department of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine) ;
  • Kim, Kyung Hwan (Department of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine) ;
  • Kim, Taehyung (Department of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine) ;
  • Lee, Joohwan (Department of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine) ;
  • Cho, Yona (Department of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine) ;
  • Koom, Woong Sub (Department of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine)
  • Received : 2012.09.11
  • Accepted : 2012.10.22
  • Published : 2012.12.30

Abstract

Purpose: 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. Materials and Methods: 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). Results: 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). Conclusion: Re-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.

Acknowledgement

Supported by : Ministry for Health, Welfare & Family Affairs

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