Sai et al. (IJROBP 2005) retrospectively analyzed 34 patients with Stage I esophageal squamous cell carcinoma that were treated with definitive radiation alone with or without intraluminal brachytherapy (ILBT). Seven patients were treated with external beam radiation alone (median dose 64 Gy), and 27 were treated with external beam radiation (median dose 52 Gy) plus ILBT (8–12 Gy in two to three fractions).
With a median follow-up of 61 months, the 5-year overall survival, local relapse-free survival, and cause-specific survival rates were 58.9%, 68.4%, and 80.0%, respectively. Also, of 9 patients with local recurrence after initial therapy, 7 were successfully treated with salvage therapy.
The authors conclude that although local recurrence was frequent within 2 years, the disease-specific survival rate was high owing to effective salvage therapy. Therefore, definitive RT is a reasonable treatment option for highly comorbid and elderly patients with Stage I esophageal cancer.
