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

PurposeThere 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. Materials and MethodsWe retrospectively reviewed 147 esophageal cancer patients who received salvage RT for locoregional 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). ResultsThe patients' median age was 65 (41-86).The median disease-free interval (DFI) 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). ConclusionSalvage RT alone as well as CCRT could be effective in patients with locoregionally recurrent esophageal cancer.