Patients with recurrence after surgery for cancer of the esophagus are given palliative treatment to relieve symptoms. However, very little is known about optimal management and duration of survival after recurrence of cancer. Patients who relapse after surgery alone as primary treatment have more options than patients who were treated initially with combined treatment.
Doctors in France have reported the management of 19 patients with recurrence of esophageal squamous cell cancer after surgical treatment. Thirteen patients had recurrences in the local area and 6 had metastatic cancer. The treatment of recurrence utilized combined chemotherapy and radiation therapy for 12 patients. Other treatments included chemotherapy alone, esophageal prosthesis or surgery.
There were 7 objective responses among the group treated with chemotherapy and radiation therapy and none in the patients treated with chemotherapy alone. Survival of the 12 patients treated by combined radiation and chemotherapy was 66% at one year and 22% at 2 years with an average survival time of 16 months.
These doctors concluded that active medical treatment of recurrent cancer of the esophagus by combined chemotherapy and radiation therapy provided a significant prolongation of survival with moderate toxicity. (Gastroenterology Clinical Biology, Vol 21, pp 287-292, 1997)