3-D conformal therapy for postradiation recurrent esophageal carcinoma

Objective To evaluate the feasibility of reirradiation for postradiation recurrent esophageal carcinoma using 3-dimensional conformal radiotherapy(3D-CRT)and to assess the immediate response and acute side-effect.Methods38 esophageal carcinoma patients with local recurrence after their initial radiotherapy received retreatment with 3-DCRT.The immediate response and acuate side effect were evaluated.ResultsAll 38 patients completed their second-course radiotherapy.The median period between the course was 19 months(12-32).The median radiation therapy dose to the gross tumor volume(GTV)was 54 Gy(50-60 Gy).The overall immediate response rate(CR+PR)was63.1%(24/38).According to the RTOG criterion,Grade 1-2 acute radiation esopiagitis occurred in 71%(27/38)and Grade 3 occurred in5.3%(2/38).Grade 1-2 acute radiation pneumonitic occurred in13.1(5/38)patients.Grade 1-2 bone marrow suppression occurred in 31.6(12/38)of patients and Grade 1-2 myocardial injury was present in 7.8(3/38)of patients.The median follow-up duration was 5 months.Conclusion3-D conformal radiotherapy can be considered as an effective and feasible approach to re-treat postradiation local reccurrence of esophageal carcinoma with good response and without any early serious complications.Long-terms survival and possible specific injury should await further study.