Short-Course External Beam Radiotherapy Versus Brachytherapy for Palliation of Dysphagia in Esophageal Cancer
| Autor: | Jeene, P.M., Vermeulen, B.D., Rozema, T., Braam, P.M., Lips, I., Muller, K., Kampen, D. van, Homs, M.Y.V., Oppedijk, V., Berbee, M., Rossum, P.S.N. van, Sharouni, S. el, Siersema, P.D., Hulshof, M.C.C.M., POLDER Study Grp |
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| Přispěvatelé: | Graduate School, Radiotherapy, CCA - Cancer Treatment and Quality of Life, Radiotherapie, MUMC+: MA Radiotherapie OC (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Medical Oncology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Esophageal Neoplasms CARCINOMA medicine.medical_treatment Brachytherapy Esophageal cancer External beam radiotherapy Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center 0302 clinical medicine SDG 3 - Good Health and Well-being medicine MANAGEMENT Humans Prospective Studies Prospective cohort study business.industry FRACTIONATION SINGLE-DOSE BRACHYTHERAPY Stent Dysphagia medicine.disease Radiation therapy Palliation 030104 developmental biology Oncology 030220 oncology & carcinogenesis Cohort Radiology medicine.symptom business Deglutition Disorders |
| Zdroj: | Journal of thoracic oncology, 15(8), 1361-1368. International Association for the Study of Lung Cancer Journal of Thoracic Oncology, 15, 1361-1368 Journal of Thoracic Oncology, 15(8), 1361-1368. Elsevier Science Journal of Thoracic Oncology, 15(8), 1361-1368. ELSEVIER SCIENCE INC Journal of Thoracic Oncology, 15, 8, pp. 1361-1368 Journal of Thoracic Oncology, 15(8), 1361-1368. International Association for the Study of Lung Cancer |
| ISSN: | 1556-1380 1556-0864 |
| Popis: | Introduction: Short-course external beam radiotherapy (EBRT) and intraluminal brachytherapy are both accepted treatments for the palliation of dysphagia in patients with incurable esophageal cancer. We compared the effects of both treatments from two prospective studies.Methods: We performed a multicenter prospective cohort study of patients with metastasized or otherwise incurable esophageal cancer requiring palliation of dysphagia from September 2016 to March 2019. Patients were treated with EBRT in five fractions of 4 Gy. Data were compared with all patients treated with a single brachytherapy dose of 12 Gy in the SIREC (Stent or Intraluminal Radiotherapy for inoperable Esophageal Cancer) trial, both between the original cohorts and between 1:1 propensity score-matched cohorts. The primary end point was an improvement of dysphagia at 3 months without reintervention. The secondary end points included toxicity and time-to-effect.Results: A total of 115 patients treated with EBRT and 93 patients who underwent brachytherapy were eligible for analysis. In the original cohorts, dysphagia improved after EBRT in 79% of patients compared with 64% after brachytherapy (p = 0.058). Propensity score matching resulted in 69 patients in each cohort well-balanced at baseline. Improvement of dysphagia was observed in 83% after EBRT versus 64% after brachytherapy (p = 0.048). In responding patients, improvement of dysphagia at 2 weeks was observed in 67% after EBRT compared with 35% after brachytherapy, and the maximum effect was reached after 4 weeks in 55% and 33%, respectively. Severe toxicity occurred in 3% of patients after EBRT compared with 13% after brachytherapy.Conclusions: Short-course EBRT appears at least as effective as brachytherapy in the palliation of dysphagia in patients with esophageal cancer. (C) 2020 International Association for the Study of Lung Cancer. Published by Elsevier Inc. |
| Databáze: | OpenAIRE |
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