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Salvage high-dose-rate brachytherapy for esophageal cancer in previously irradiated patients: A retrospective analysis.

Abstract：

PURPOSE:To evaluate outcomes after exclusive salvage high-dose-rate (HDR) intraluminal esophageal brachytherapy given to previously irradiated patients with recurrent esophageal cancer. METHODS AND MATERIALS:We reviewed medical records of 30 patients who were treated by salvage HDR brachytherapy for local esophageal cancer. Brachytherapy delivered four to six fractions of 5-7 Gy at 5 mm from the applicator surface and 20 mm above and below the macroscopic tumor volume. RESULTS:Eighty percentage of patients received treatment as initially planned. Complete response rate, evaluated 1 month after brachytherapy by endoscopy and biopsy, was 53%. Squamous histology and complete endoscopic tumor response at 1 month were significantly associated with better local tumor control. Median local progression-free survival was 9.8 months. Overall survival was 31.5% and 17.5% at 1 and 2 years, respectively. On univariate analysis, preserved performance status and limited weight loss (<10%) before salvage brachytherapy were associated with better overall survival. Severe toxicity (Grade ≥3) occurred in 7 patients (23%). CONCLUSIONS:Although esophageal cancer in previously irradiated patients is associated with poor outcomes, HDR brachytherapy may be a valuable salvage treatment for inoperable patients with locally limited esophageal cancer, particularly in the subset of patients with preserved performance status and limited weight loss (≤10%) before salvage brachytherapy.

journal_name

Brachytherapy

journal_title

Brachytherapy

authors

Wong Hee Kam S,Rivera S,Hennequin C,Lourenço N,Chirica M,Munoz-Bongrand N,Gornet JM,Quéro L

doi

10.1016/j.brachy.2015.02.392

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

531-6

issue

4

eissn

1538-4721

issn

1873-1449

pii

S1538-4721(15)00420-1

journal_volume

14

pub_type

杂志文章

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