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Endoscopic Salvage Following Radiotherapy for Oesophageal Cancer: A Systematic Review
H L Keenan1, R A Brooks1, C M Jones2
1Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|August 8, 2026
Summary
Endoscopic salvage after definitive chemoradiotherapy (dCRT) for oesophageal cancer is feasible. This approach offers a less invasive alternative to surgery for residual or recurrent disease, with promising survival rates for oesophageal squamous cell carcinoma (OSCC).
Area of Science:
- Gastroenterology and Endoscopy
- Oncology
- Radiotherapy
Background:
- Definitive chemoradiotherapy (dCRT) is standard for locally advanced oesophageal cancer (OSCC and OAC).
- Endoscopic resection is an alternative to surgery for post-dCRT residual or recurrent disease.
- The safety and effectiveness of endoscopic salvage after dCRT require systematic assessment.
Purpose of the Study:
- To systematically review the toxicity and efficacy of endoscopic salvage for oesophageal cancer post-dCRT.
- To assess outcomes of endoscopic management for residual or recurrent disease following dCRT.
Main Methods:
- Systematic review following PRISMA guidelines.
- Searched PubMed, Medline, Cochrane Library, Scopus, Web of Science, and EMBASE (Jan 1990–Dec 2025).
- Extracted data on tolerability, toxicity, and efficacy of endoscopic salvage procedures.
Main Results:
- 45 studies included 1970 lesions (976 resections, 548 PDT), mostly OSCC.
- 3- and 5-year overall survival ranged from 35-81% and 36-75%.
- Adverse events: stricture (0-21% endoscopic resection), chest pain (25-54.9% PDT); no deaths from resection, 5 from PDT.
Conclusions:
- Endoscopic salvage is feasible for OSCC post-dCRT, with low-quality evidence of safety and efficacy.
- Limited data exist for endoscopic salvage in OAC.
- Prospective studies are needed to evaluate survival, adverse events, and quality of life for both OSCC and OAC.