Postoperative radiotherapy for resected esophageal squamous cell carcinoma: a systematic review and meta-analysis
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By
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Ning Zhou
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Peipei Zhao
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Miaomiao Zhao
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Fen Wen
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Wei Geng
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Zhenhua Liu
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July 14, 2026
Clinical Scorecard: Evaluating Post-Surgical Radiotherapy in Patients with Resected Esophageal Squamous Cell Carcinoma: A Comprehensive Meta-Analysis
At a Glance
| Category | Detail |
|---|
| Condition | Esophageal Squamous Cell Carcinoma (ESCC) |
| Key Mechanisms | Postoperative radiotherapy (PORT) improves overall survival (OS) and disease-free survival (DFS) while reducing locoregional recurrence (LRR). |
| Target Population | Patients with radically resected ESCC. |
| Care Setting | Oncology |
Key Highlights
- PORT significantly improves OS (HR = 0.74) and DFS (HR = 0.62) compared to surgery alone.
- PORT reduces LRR (OR = 0.30) but has no effect on distant metastasis (OR = 1.01).
- The addition of chemotherapy enhances OS benefit (HR = 0.55).
- PORT is associated with increased grade ≥3 acute toxicity (OR = 2.45), primarily radiation esophagitis and leukopenia.
- A radiation dose of 50 Gy is recommended for optimal benefit.
Guideline-Based Recommendations
Diagnosis
- Histologically confirmed ESCC undergoing curative resection.
Management
- Consider PORT for patients with high-risk features such as positive lymph nodes and advanced T stage.
Monitoring & Follow-up
- Monitor for acute toxicity, particularly radiation esophagitis and leukopenia.
Risks
- Increased incidence of grade ≥3 acute toxicity.
Patient & Prescribing Data
Patients with radically resected ESCC.
PORT improves survival outcomes, especially in patients with high-risk features.
Clinical Best Practices
- Utilize modern radiotherapy techniques (3D-CRT/IMRT) for better outcomes.
- Incorporate chemotherapy with PORT for enhanced survival benefits.
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