Definitive re‑irradiation of locally recurrent esophageal cancer after trimodality therapy in patients with a poor performance status
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- Published online on: May 11, 2020 https://doi.org/10.3892/mco.2020.2044
- Pages: 27-32
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Copyright: © Kim et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
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Abstract
There are few treatment guidelines for locally recurrent esophageal cancer after trimodality treatment (pre‑operative chemoradiation followed by surgery) in patients with a poor performance status. The purpose of this single institutional, retrospective study was to evaluate the clinical outcomes and toxicities of definitive‑intent re‑irradiation for patients with recurrent esophageal cancer with a poor performance status [ECOG (Eastern Cooperative Oncology Group) ≥2]. Seven patients were identified with a median age of 74 years (range, 61‑81 years). Four patients were ECOG 2 and three patients were ECOG 3. The median follow‑up time after re‑irradiation was 49 months. The median interval between initial radiotherapy and re‑treatment was 32 months. Six patients received concurrent chemotherapy [carboplatin + paclitaxel in three patients; folinic acid, fluorouracil, oxaliplatin (FOLFOX) + 5‑fluorouracil in one patient; FOLFOX in one patient, and capecitabine in one patient]. At the last follow‑up, the six patients who underwent concurrent chemotherapy had stable disease (86%), while the one who did not receive chemotherapy progressed (14%). Two patients developed metastases. Three patients developed acute (<6 months) grade 4 toxicities (dysphagia, anemia, esophagitis). There were no early deaths attributable to treatment. Late toxicities (>6 months) were limited to grades 1 and 2 dysphagia and pneumonitis in four patients. In conclusion, definitive re‑irradiation of recurrent esophageal cancer in patients with a poor performance status appears to be safe with acceptable acute toxicity and late complications. It also appears to result in durable local control when combined with chemotherapy, albeit with a small number of patients and limited follow‑up.
