Definitive salvage radiation therapy and chemoradiation therapy for lymph node oligo-recurrence of esophageal cancer

A Japanese multi-institutional study of 237 patients

Hideomi Yamashita, Keiichi Jingu, Yuzuru Niibe, Kuniaki Katsui, Toshihiko Matsumoto, Tomohiro Nishina, Atsuro Terahara

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: This study evaluated the treatment results of lymph node (LN) oligo-recurrence in esophageal cancer patients treated with salvage radiotherapy (RT) in a multi-institutional retrospective study. Methods: Eligibility criteria for this retrospective analysis were: the primary lesion of esophageal cancer was controlled; from one to five LN recurrences; total RT dose ≥45 Gy to exclude palliative RT; without recurrence other than LN; and salvage RT for LN recurrence was given between January 2000 and April 2015. The median follow-up time for the 93 living patients was 29.6 months. Results: Two hundred thirty-seven patients were matched in five hospitals. The 3-year overall survival (OS) was 37%, local control was 45%, progression-free survival was 24%, and esophageal cancer-specific survival was 42%. On univariate analysis for OS, combined chemotherapy (p = 0.000055), disease-free interval (DFI) ≥12 months (p = 0.0013), LN max diameter ≤22 mm (p = 0.0052), and Karnofsky performance status ≥80% (p = 0.030) were associated with a significantly better prognosis. On multivariate analysis, significant differences were seen for combined chemotherapy (p = 0.000018), DFI (p = 0.0027), and LN max diameter (p = 0.018). Conclusions: LN oligo-recurrence following treatment for esophageal cancer was not a terminal-stage event. Moreover, cure may be possible by chemoradiation therapy with a long DFI (≥12 months) and small size (≤22 mm).

Original languageEnglish
Article number38
JournalRadiation Oncology
Volume12
Issue number1
DOIs
Publication statusPublished - Feb 20 2017

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Salvage Therapy
Esophageal Neoplasms
Radiotherapy
Lymph Nodes
Recurrence
Therapeutics
Karnofsky Performance Status
Drug Therapy
Survival
Survival Analysis
Disease-Free Survival
Multivariate Analysis
Retrospective Studies

Keywords

  • Esophageal cancer
  • Oligo-recurrence
  • Oligometastases
  • Salvage chemoradiation therapy
  • Salvage radiation therapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Definitive salvage radiation therapy and chemoradiation therapy for lymph node oligo-recurrence of esophageal cancer : A Japanese multi-institutional study of 237 patients. / Yamashita, Hideomi; Jingu, Keiichi; Niibe, Yuzuru; Katsui, Kuniaki; Matsumoto, Toshihiko; Nishina, Tomohiro; Terahara, Atsuro.

In: Radiation Oncology, Vol. 12, No. 1, 38, 20.02.2017.

Research output: Contribution to journalArticle

Yamashita, Hideomi ; Jingu, Keiichi ; Niibe, Yuzuru ; Katsui, Kuniaki ; Matsumoto, Toshihiko ; Nishina, Tomohiro ; Terahara, Atsuro. / Definitive salvage radiation therapy and chemoradiation therapy for lymph node oligo-recurrence of esophageal cancer : A Japanese multi-institutional study of 237 patients. In: Radiation Oncology. 2017 ; Vol. 12, No. 1.
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abstract = "Background: This study evaluated the treatment results of lymph node (LN) oligo-recurrence in esophageal cancer patients treated with salvage radiotherapy (RT) in a multi-institutional retrospective study. Methods: Eligibility criteria for this retrospective analysis were: the primary lesion of esophageal cancer was controlled; from one to five LN recurrences; total RT dose ≥45 Gy to exclude palliative RT; without recurrence other than LN; and salvage RT for LN recurrence was given between January 2000 and April 2015. The median follow-up time for the 93 living patients was 29.6 months. Results: Two hundred thirty-seven patients were matched in five hospitals. The 3-year overall survival (OS) was 37{\%}, local control was 45{\%}, progression-free survival was 24{\%}, and esophageal cancer-specific survival was 42{\%}. On univariate analysis for OS, combined chemotherapy (p = 0.000055), disease-free interval (DFI) ≥12 months (p = 0.0013), LN max diameter ≤22 mm (p = 0.0052), and Karnofsky performance status ≥80{\%} (p = 0.030) were associated with a significantly better prognosis. On multivariate analysis, significant differences were seen for combined chemotherapy (p = 0.000018), DFI (p = 0.0027), and LN max diameter (p = 0.018). Conclusions: LN oligo-recurrence following treatment for esophageal cancer was not a terminal-stage event. Moreover, cure may be possible by chemoradiation therapy with a long DFI (≥12 months) and small size (≤22 mm).",
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AU - Niibe, Yuzuru

AU - Katsui, Kuniaki

AU - Matsumoto, Toshihiko

AU - Nishina, Tomohiro

AU - Terahara, Atsuro

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N2 - Background: This study evaluated the treatment results of lymph node (LN) oligo-recurrence in esophageal cancer patients treated with salvage radiotherapy (RT) in a multi-institutional retrospective study. Methods: Eligibility criteria for this retrospective analysis were: the primary lesion of esophageal cancer was controlled; from one to five LN recurrences; total RT dose ≥45 Gy to exclude palliative RT; without recurrence other than LN; and salvage RT for LN recurrence was given between January 2000 and April 2015. The median follow-up time for the 93 living patients was 29.6 months. Results: Two hundred thirty-seven patients were matched in five hospitals. The 3-year overall survival (OS) was 37%, local control was 45%, progression-free survival was 24%, and esophageal cancer-specific survival was 42%. On univariate analysis for OS, combined chemotherapy (p = 0.000055), disease-free interval (DFI) ≥12 months (p = 0.0013), LN max diameter ≤22 mm (p = 0.0052), and Karnofsky performance status ≥80% (p = 0.030) were associated with a significantly better prognosis. On multivariate analysis, significant differences were seen for combined chemotherapy (p = 0.000018), DFI (p = 0.0027), and LN max diameter (p = 0.018). Conclusions: LN oligo-recurrence following treatment for esophageal cancer was not a terminal-stage event. Moreover, cure may be possible by chemoradiation therapy with a long DFI (≥12 months) and small size (≤22 mm).

AB - Background: This study evaluated the treatment results of lymph node (LN) oligo-recurrence in esophageal cancer patients treated with salvage radiotherapy (RT) in a multi-institutional retrospective study. Methods: Eligibility criteria for this retrospective analysis were: the primary lesion of esophageal cancer was controlled; from one to five LN recurrences; total RT dose ≥45 Gy to exclude palliative RT; without recurrence other than LN; and salvage RT for LN recurrence was given between January 2000 and April 2015. The median follow-up time for the 93 living patients was 29.6 months. Results: Two hundred thirty-seven patients were matched in five hospitals. The 3-year overall survival (OS) was 37%, local control was 45%, progression-free survival was 24%, and esophageal cancer-specific survival was 42%. On univariate analysis for OS, combined chemotherapy (p = 0.000055), disease-free interval (DFI) ≥12 months (p = 0.0013), LN max diameter ≤22 mm (p = 0.0052), and Karnofsky performance status ≥80% (p = 0.030) were associated with a significantly better prognosis. On multivariate analysis, significant differences were seen for combined chemotherapy (p = 0.000018), DFI (p = 0.0027), and LN max diameter (p = 0.018). Conclusions: LN oligo-recurrence following treatment for esophageal cancer was not a terminal-stage event. Moreover, cure may be possible by chemoradiation therapy with a long DFI (≥12 months) and small size (≤22 mm).

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KW - Oligo-recurrence

KW - Oligometastases

KW - Salvage chemoradiation therapy

KW - Salvage radiation therapy

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