Case Report
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World J Gastrointest Oncol. Feb 15, 2014; 6(2): 52-54
Published online Feb 15, 2014. doi: 10.4251/wjgo.v6.i2.52
Extended cancer-free survival after palliative chemoradiation for metastatic esophageal cancer
Hideomi Yamashita, Kae Okuma, Akihiro Nomoto, Mami Yamashita, Hiroshi Igaki, Keiichi Nakagawa
Hideomi Yamashita, Akihiro Nomoto, Mami Yamashita, Hiroshi Igaki, Departments of Radiology, University of Tokyo Hospital, Tokyo 113-8655, Japan
Kae Okuma, Keiichi Nakagawa, Departments of Palliative Care Unit, University of Tokyo Hospital, Tokyo 113-8655, Japan
Author contributions: Yamashita H, Igaki H and Nakagawa K designed the report; Nomoto A and Yamashita M performed the genetic analyses; Yamashita H and Okuma K collected the patient’s clinical data; Yamashita H, Igaki H and Nakagawa K analyzed the data and wrote the paper.
Correspondence to: Dr. Hideomi Yamashita, MD, PhD, Department of Radiology, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. yamachan07291973@yahoo.co.jp
Telephone: +81-3-58008667 Fax: +81-3-58008935
Received: October 14, 2013
Revised: December 22, 2013
Accepted: January 6, 2014
Published online: February 15, 2014
Processing time: 123 Days and 20.5 Hours
Abstract

We report on a patient who remained cancer-free for an extended time after palliative radiotherapy (RT) and chemotherapy (nedaplatin plus 5-fluorouracil) treatment for stage IV (cT3N3M1) esophageal squamous cell carcinoma. Although multiple lymph nodes outside the RT field recurred, the local primary tumor within the RT field did not recur, even 17 mo after palliative RT of 30 Gy in 10 fractions. In this case, acute toxicity, such as myelosuppression or esophagitis, was not enhanced by increasing the fraction dose from 1.8-2.0 Gy to 3.0 Gy. Because 30 Gy in 10 fractions can be completed within a shorter time and is less expensive than 50.4 Gy in 28 fractions, we think that 30 Gy without oblique beams is a more favorable RT method for patients.

Keywords: Radiotherapy; Chemotherapy; Esophageal cancer; Esophageal stenosis; Metastatic esophageal cancer

Core tip: The palliative therapy method has not been confirmed for metastatic esophageal cancer. This case report represents a patient who was cancer-free for an extended period of time after palliative chemoradiation of 30 Gy in 10 fractions. We think that 30 Gy without oblique beams is a more favorable radiotherapy method for patients.