Comparative evaluation between re-irradiation and demand endoscopic dilatation vs endoscopic dilatation alone in patients with recurrent/reactivated residual in-field esophageal malignancies

Teli, M Ashraf; Mushood, G Nabi; Zargar, Showkat Ali; Andrabi, Wajahat H

doi:10.4103/0973-1482.43140

Cited by 7 publications

(2 citation statements)

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“…Concerning the potentially serious complications, re-RT was performed in a small and highly selected group of patients in clinical practice. In a prospective and randomized study, which included 34 patients who received re-RT and 35 patients who received dilatation alone, 6 cases of TEF were observed in the non-re-RT group, while no case of TEF was found in the re-RT group [ 21 ]. In the current study, no statistical differences were found in the incidence of TEF ( P = 0.613) and pericardial/pleural effusion ( P = 0.197) between re-RT and non-re-RT groups.…”

Section: Discussionmentioning

confidence: 99%

Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis

et al. 2018

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BackgroundTo investigate the treatment failure pattern and factors influencing locoregional recurrence of esophageal squamous cell carcinoma (ESCC) and examine patient survival with re-irradiation (re-RT) after primary radiotherapy.MethodsWe retrospectively analyzed 87 ESCC patients treated initially with radiotherapy. Failure patterns were classified into regional lymph node recurrence only (LN) and primary failure with/without regional lymph node recurrence (PF). Patients received either re-RT or other treatments (non-re-RT group). Baseline covariates were balanced by a propensity score model. Overall survival (OS) and toxicities were assessed as outcomes.ResultsThe median follow-up time was 87 months. Thirty-nine patients received re-RT. Failure pattern and re-RT were independent prognostic factors for OS (P = 0.040 and 0.015) by Cox multivariate analysis. Re-RT with concomitant chemotherapy showed no survival benefit over re-RT alone (P = 0.70). No differences in characteristics were found between the groups by Chi-square tests after propensity score matching. The Cox model showed that failure pattern and re-RT were prognostic factors with hazard ratios (HR) of 0.319 (P = 0.025) and 0.375 (P = 0.002), respectively, in the matched cohort. Significant differences in OS were observed according to failure pattern (P = 0.004) and re-RT (P < 0.001). In the re-RT and non-re-RT groups, 9.09% and 3.03% of patients experienced tracheoesophageal fistulas, and 15.15% and 3.03% of patients developed pericardial/pleural effusion, respectively (P > 0.05). The incidence of radiation pneumonitis was higher in the re-RT group (24.24% vs. 6.06%, P = 0.039), but no cases of pneumonia-related death occurred.ConclusionsRe-RT improved long-term survival in patients with locoregional recurrent ESCC. Despite a high incidence of radiation pneumonitis, toxicities were tolerable.

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Section: Discussionmentioning

confidence: 99%

Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis

et al. 2018

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“…Teli et al [13] reported a prospective and randomized study that included 34 patients who were palliated with re-RT and 35 patients who refused re-RT and received peroral demand dilatation alone. Patients in the re-RT group showed better and more sustained improvement in their grade of dysphagia.…”

Section: Discussionmentioning

confidence: 99%

Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy

et al. 2012

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PurposeFor recurrent esophageal cancer after primary definitive radiotherapy, no general treatment guidelines are available. We evaluated the toxicities and clinical outcomes of re-irradiation (re-RT) for recurrent esophageal cancer.Materials and MethodsWe analyzed 10 patients with recurrent esophageal cancer treated with re-RT after primary definitive radiotherapy. The median time interval between primary radiotherapy and re-RT was 15.6 months (range, 4.8 to 36.4 months). The total dose of primary radiotherapy was a median of 50.4 Gy (range, 50.4 to 63.0 Gy). The total dose of re-RT was a median of 46.5 Gy (range, 44.0 to 50.4 Gy).ResultsThe median follow-up period was 4.9 months (range, 2.6 to 11.4 months). The tumor response at 3 months after the end of re-RT was complete response (n = 2), partial response (n = 1), stable disease (n = 2), and progressive disease (n = 5). Grade 5 tracheoesophageal fistula developed in three patients. The time interval between primary radiotherapy and re-RT was less than 12 months in two of these three patients. Late toxicities included grade 1 dysphagia (n = 1).ConclusionRe-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.

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Esophageal Cancer: Radiation Therapy Planning

Boyer

Willett

Palta

et al. 2017

Radiation Therapy for Gastrointestinal Cancers

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Comparative evaluation between re-irradiation and demand endoscopic dilatation vs endoscopic dilatation alone in patients with recurrent/reactivated residual in-field esophageal malignancies

Abstract: A trial of re-irradiation with external beam is justified in selected patients.

Cited by 7 publications

References 0 publications

Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis

Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis

Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy

Esophageal Cancer: Radiation Therapy Planning

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