Re-irradiation for recurrent esophageal cancer: clinical benefit, survival outcomes, and toxicity profile
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background and purpose: To evaluate survival and toxicity in patients with recurrent esophageal cancer treated with curative (cRT) and palliative (pRT) reirradiation. Materials and methods: From May 2015 to August 2024, 41 patients with locally recurrent esophageal cancer received cRT or pRT. Toxicity was assessed using CTCAE v5.0. Overall survival (OS) was analyzed using the Kaplan-Meier method. Clinical benefit of pRT (reduction in dysphagia, pain or bleeding) was assessed 4 weeks after reRT. Results: The cohort consisted of 41 patients (median age 73 years). At reirradiation, 36 patients received pRT (20 Gy/5fx or 30 Gy/10fx), and 5 received cRT (50.4 Gy/28fx with chemotherapy). Sixteen patients (39%) had metastatic disease (M1). Median OS was 11.9 months for M0 cRT, 9.8 months for M0 pRT, and 2.8 months for M1 pRT (p = 0.003). The pRT provided clinical benefit in 72% of patients: the median OS for M0 patients who did and did not experience symptoms improvement from reirradiation was 9.8 and 5 months, respectively; M1 patients with and without therapeutic effect had a median OS of 4.5 and 2.2 months, respectively (p < 0.001). Acute toxicity was low, with 5 pRT patients requiring a nasogastric tube and 1 patient developing grade 3 skin toxicity. No grade ≥ 4 toxicities were reported. Conclusion: Palliative reirradiation in patients with recurrent esophageal cancer showed clinical benefit in 72% of the patients, with impact on OS both in M0 and M1 patients and low rate of acute toxicity. These findings support the use of reirradiation as a feasible and effective strategy in selected patients with recurrent esophageal cancer.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,430
OpenAlex ID: W4415899752