P-050 - The role of radiotherapy or chemoradiotherapy for oligo-recurrence of esophageal cancer after curative resection or chemoradiotherapy

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Pancreatic Cancer
Surgery and/or Radiotherapy of Cancer
Presenter T. Matsumoto
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors T. Matsumoto1, T. Nishina1, T. Kajiwara1, K. Uwazu1, A. Nishikawa1, Y. Niibe2, M. Kataoka1
  • 1Shikoku Cancer Center, Matsuyama/JP
  • 2Toho University Medical Center Omori Hospital, Tokyo/JP

Abstract

Introduction

To investigate the efficacy and safety of radiotherapy or chemoradiotherapy in patients with oligo-recurrence esophageal cancer after curative resection or chemoradiotherapy.

Methods

Between January 1999 and March 2013, 41 patients with oligo-recurrence esophageal cancer were treated radiotherapy or chemoradiotherapy for recurrent lymph node. The histologic type of all patients was squamous cell carcinoma.

Results

As for treatment of primary esophageal lesions, 29 patients received curative surgery, 11 patients received chemoradiotherapy, and 1 patient received endoscopic mucosal dissection. All patients had controlled primary esophageal lesions. Median follow up period from the treatment of primary esophageal lesions was 17.8 months (range: 0.6-141.4months). In the current study, registered patients had only lymph nodes recurrences. Cervical lymph node recurrence was found in 10 patients, mediastinal lymph node recurrence was found in 26 patients, and abdominal lymph node recurrence was found in 8 patients. 32 patients received chemoradiotherapy and 9 patients received radiotherapy. The median disease-free interval (DFI) was 14.4 months (range: 4.5-103.3 months). The median radiotherapy dose was 54.1Gy (range: 18-66Gy). Response rate was 84.6%(CR/PR/SD/PD/NE: 27/6/5/1/2) and 3 year local control rate was 55.7%. Median overall survival (OS) was 19.9 months (95%CI: 9.9-42.3 months) and 3 years survival rate was 19.5%. The OS of patients with DFI ≥12 months was significantly longer than that of the patients with DFI <12 months (9.9 months vs 42.3 months, p = 0.024). The discontinuation of the treatment with toxicity was only one case. 4 treatment-related deaths were observed, 3 patients died of the fistula of esophagus and lymph nodes and 1 patient died of bleeding from a gastric ulcer. In all patients with treatment-related death, recurrent lymph nodes invaded other organs.

Conclusion

Radiotherapy or chemoradiotherapy is effective for oligo-recurrence of esophageal cancer. Among them, DFI > 12 months patients had longer time survival than that of DFI < 12 months. However, it was retrospective study for small population in single institution. Further large study, if possible prospective study, will be required.