Re-irradiation for esophageal cancer

While recurrent esophageal cancer is a common clinical scenario, limited data exist regarding management approaches that include re-irradiation. Tremendous technological advances in the treatment planning and delivery of radiotherapy pave the way to evaluate the appropriateness of re-irradiation in the management of radio-recurrent esophageal cancer. Patients with radio-recurrent esophageal cancer may still be selected for a potentially curative treatment, especially those in good clinical condition, who may experience prolonged survival and good symptom control rates. None of the different therapeutic options is carried out without potentially life-threatening treatment-related toxicities in a relevant proportion of the patients. In this scenario, patient selection performed on individual basis could help to identify the most appropriate treatment modality, including re-irradiation with cutting-edge techniques. Enrollment of these patients in clinical trials is highly warranted.