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
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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