External beam radiotherapy combined with intraluminal brachytherapy in esophageal carcinoma
Autor: | Veronique E.M. Mul, J. T. Plukker, Johannes A. Langendijk, Christina T. Muijs, Nanna M. Sijtsema, Jannet C. Beukema |
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Přispěvatelé: | Damage and Repair in Cancer Development and Cancer Treatment (DARE), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Targeted Gynaecologic Oncology (TARGON) |
Rok vydání: | 2012 |
Předmět: |
Male
Esophageal Neoplasms medicine.medical_treatment Esophageal cancer Brachytherapy PROGNOSTIC-FACTORS THORACIC ESOPHAGUS Treatment Failure COMBINED CHEMORADIOTHERAPY Aged 80 and over Radiotherapy Dosage Hematology CHEMOTHERAPY Middle Aged CANCER Survival Rate Treatment Outcome medicine.anatomical_structure Oncology Lymphatic Metastasis Intraluminal brachytherapy Female SQUAMOUS-CELL CARCINOMA medicine.medical_specialty Perforation (oil well) medicine Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Esophagus DOSE-RATE BRACHYTHERAPY Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Pneumonitis Radiotherapy business.industry medicine.disease RANDOMIZED-TRIAL Surgery Radiation therapy Logistic Models Dose Fractionation Radiation Neoplasm Recurrence Local FOLLOW-UP Tomography X-Ray Computed business Esophagitis DEFINITIVE RADIATION-THERAPY |
Zdroj: | Radiotherapy and Oncology, 102(2), 303-308. ELSEVIER IRELAND LTD |
ISSN: | 0167-8140 |
Popis: | Purpose: To assess the effectiveness of definitive radiation therapy in patients with potentially curable esophageal cancer and to evaluate the side-effects of this treatment.Methods and materials: Sixty-two patients with esophageal cancer, who were treated with definitive, curatively intended radiotherapy consisting of external radiotherapy (60 Gy in 30 fractions), preceded and followed by LDR or HDR intraluminal brachy (12 Gy in 2 fractions) were retrospectively analyzed.Results: Recurrences were reported in 38 patients (61%), of which 25(64%) failed locally first.Results: The overall survival rates at 1,2 and 5 years were 57%, 34% and 11%, respectively. The median overall survival was 15 months. No prognostic factors could be identified. Most frequently reported treatment related toxicities were esophagitis, ulcerations, (11%) and strictures (16%). In 10 patients (16%) severe toxicities, were reported including grade III ulceration (2 cases), stricture (1 case), radiation pneumonitis (1 case), perforation (1 case), esophageal-pleural-tracheal fistula (1 case), and acute esophageal bleeding (4 cases). A history of gastrectomy was significantly associated with the development of severe toxicity.Conclusion: Curatively intended radiotherapy alone can be offered to esophageal cancer patients, even when surgery and/or chemotherapy are not feasible. However, we observed severe toxicity in a substantial part of the patients. Given the relatively high rate of severe complications and the uncertainties regarding dose escalation, the addition of brachytherapy, with consequently high surface doses, should be limited to well-selected patients. (C) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 102 (2012) 303-308 |
Databáze: | OpenAIRE |
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