Analysis of intensity-modulated radiation therapy in 45 patients with local recurrence of esophageal cancer after radiotherapy

Objective:To evaluate the feasibility, short-term curative effect, adverse reaction and its related factors of intensity-modulated radiation therapy(IMRT) in patients with local recurrence of esophageal cancer after radiotherapy.Methods:Forty-five patients with local recurrence of esophageal cancer after radiotherapy were treated with 1.8 to 2.0 Gy of IMRT 5 times a week, a median total dose for 50.4 Gy(range from 45 to 60 Gy).Results:Among 45 patients, the re-irradiation therapy in 42 patients were completed, complete response in 8 cases, partial response in 27 cases and stable disease in 7 cases were found.Grade 2 and grade 3 acute radiation esophagitis occurred in 18 cases and 2 cases, respectively.Grade 2 and grade 3 acute radiation pneumonitis occurred in 7 cases and 1 case, respectively, and the patients relieved after active treatment.Five patients occurred the perforation of esophagus in 3 months after radiotherapy, and died within 6 months.Three patients terminated the radiation because of the general deterioration, 1 patient died because of pneumorrhagia in six months after radiotherapy.The total survival rates of 1 and 2-year were 40.0% and 17.8%, respectively.The patients with complete remission survived over 2 years.Conclusions:The treatment of patients with local recurrence of esophageal cancer after radiotherapy with IMRT is effective, which has certain remission rate and high complication.The perforation of esophagus and more than grade 3 radiation pneumonitis should be alerted.