Clinical study of salvage strategy for patients with locally recurrent esophageal cancer after definitive radiochemotherapy
Chen Yongshun1, Cheng Xinyu2, Song Haixia3, Ke Shaobo1, Cheng Guowei4, Shi Wei1, Qiu Hu1, Gao Yi1, Chen Jiamei1
1Department of Clinical Oncology,Renmin Hospital of Wuhan University,Wuhan 430060,China; 2Department of Radiation Oncology,Anyang Tumor Hospital,Anyang 455000,China; 3Department of Radiation Oncology,Gansu Cancer Hospital,Lanzhou 730050,China; 4Department of Radiation Oncology,Cancer Hospital of Huanxing of Beijing Chaoyang District,Beijing 100122,China
Abstract：Objective To investigate the salvage strategy and efficacy for patients with locally recurrent esophageal squamous cell carcinoma after definitive radiochemotherapy. Methods A total of 126 patients who met the inclusion criteria were enrolled in this study and divided into the salvage surgery, salvage radiochemotherapy and best supportive care. Results Fifty-eight of 126 patients received salvage esophagectomy, 52 underwent salvage radiochemotherapy and the remaining 16 patients received best supportive care. The 1-,3-,5-year overall survival rates of patients receiving salvage therapy were 51%,16% and 4% for the three groups, whereas all patients in the best supportive care group died within 12.0 months (P<0.001). The 1-,3-,5-year survival rates in the salvage surgery and salvage radiochemotherapy groups were 48%, 20% and 7%, and 51%,11% and 3%,respectively (P=0.473). Multivariate analysis by Cox proportional hazard model showed that T staging of recurrent tumors and salvage regimen were the independent prognostic factors in patients with locally recurrent esophageal cancer (both P<0.001). Postoperative infection occurred in 16% of the patients in the salvage surgery group, and the incidence of esophagotracheal fistula and mediastinoesophageal fistula was 10% and 6% in the salvage radiochemotherapy group. Conclusions A survival benefit can be elicited by salvage surgery or salvage radiochemotherapy in patients with locally recurrent esophageal cancer after definitive radiochemotherapy. Nevertheless, extensive attention should be paid to the management of postoperative complications in clinical practice.
Chen Yongshun,Cheng Xinyu,Song Haixia et al. Clinical study of salvage strategy for patients with locally recurrent esophageal cancer after definitive radiochemotherapy[J]. Chinese Journal of Radiation Oncology, 2019, 28(11): 826-829.
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2019, Vol. 28 
