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Japanese Journal of Clinical Oncology 2007 37(12):918-923; doi:10.1093/jjco/hym138
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© The Author (2008). Published by Oxford University Press. All rights reserved

Radiation Therapy for Recurrent Esophageal Cancer after Surgery: Clinical Results and Prognostic Factors

Yoshiyuki Shioyama1,, Katsumasa Nakamura1, Saiji Ohga1, Satoshi Nomoto1, Tomonari Sasaki1, Toshihiro Yamaguchi1, Takashi Toba1, Tadamasa Yoshitake1, Hiromi Terashima2 and Hiroshi Honda1

1 Department of Clinical Radiology, Graduate School of Medical Sciences Fukuoka 812-8582, Japan
2 Department of Radiation Technology, School of Health Sciences, Faculty of Medicine, Kyushu University, Fukuoka 812-8582, Japan

For reprints and all correspondence: Yoshiyuki Shioyama, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka 812-8582, Japan. E-mail: yshioyama{at}yahoo.com

Received September 19, 2006; accepted June 27, 2007

Objective: To evaluate the outcome of radiotherapy for recurrent esophageal cancer after surgery and to determine the prognostic factors.

Methods: From 1987 through 2002, 82 patients treated with radiotherapy for loco-regional recurrences of esophageal cancer after surgery were retrospectively reviewed. The stage at initial surgery was I in 16, II in 41, III or higher in 24 and unknown in 1. The median size of recurrent tumors was 3.5 cm in diameter. Fifty-two patients were treated with radiotherapy alone, and 30 were treated with radiotherapy combined with chemotherapy. The median total dose of external radiotherapy given was 50.4 Gy in 28 fractions.

Results: The median survival period after recurrence was 7.0 months. The 2- and 5-year overall survival rate for all patients was 22 and 11%, respectively. In univariate analysis, the patients with performance status (PS) = 0–1, or tumor size <3.5 cm, and those treated with total dose ≥50 Gy showed a better survival outcome than each the other groups. The patients with a history of previous radiotherapy showed a poorer survival outcome in univariate analysis than each the other groups. In multivariate analysis, tumor size, PS and radiation dose were independent prognostic factors for overall survival.

Conclusion: The prognosis of patients with post-operative loco-regional recurrence of esophageal cancer is poor. However, a long-term survival may be expected by definitive radiotherapy for the patients with small-size tumors and with a good PS.

Key Words: esophageal cancer • recurrence after surgery • radiation therapy


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