Definitive Radiotherapy for Esophageal Squamous Cell Carcinoma after Allogeneic Hematopoietic Stem Cell Transplantation with Conditioning of Total Body Irradiation
Kawamoto, T.; Nihei, K.; Doki, N.; Najima, Y.; Kaito, S.; Karasawa, K.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 45(9): 1357-1359
2018
ISSN/ISBN: 0385-0684 PMID: 30237381 Document Number: 697605
A 24-year-old man with acute lymphoblasticleukemia underwent allogeneicperipheral blood stem cell transplantation (allo-PBSCT)from a human leukocyte antigen-matched sibling after myeloablative conditioning, with a regimen including total body irradiation(TBI)(12 Gy/6 fractions), 6 years ago. The patient developed extensive chronic graft-versus-host disease(cGVHD)of the skin, mouth, liver, and gut four months after allo-PBSCT. Treatment with cyclosporine and prednisolone was necessary to control the cGVHD. Six years after allo-PBSCT, the patient experienced odynophagia and was diagnosed with cervical esophageal squamous cell carcinoma(cT1bN1M0, cStage II B). Because we considered laryngeal preservation, risk of anastomotic leakage, and infection related to the operation, the patient was planned to receive chemoradio- therapy with 5-fluorouracil and cisplatin. Regarding irradiation, the patient received radiotherapy(50.4 Gy/28 fractions)for a primary tumor and lymph node without an elective nodal area. The patient achieved complete response and remained disease- free without any treatment-related complications for 3 years.