Low-Dose Versus High-Dose Radiation Therapy for the Palliation of Dysphagia From Esophageal Cancer: A Multicenter Retrospective Cohort Study
| Autor: | H.J.T. Rutten, Pètra M. Braam, Johannes A. Bogers, Paul M. Jeene, Peter D. Siersema, Bram D. Vermeulen, Robin Krol, Jasmijn Sijben |
|---|---|
| Přispěvatelé: | Graduate School |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment 030218 nuclear medicine & medical imaging Cohort Studies 03 medical and health sciences Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] 0302 clinical medicine All institutes and research themes of the Radboud University Medical Center otorhinolaryngologic diseases Medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Adverse effect Prospective cohort study Aged Retrospective Studies business.industry Palliative Care Retrospective cohort study Esophageal cancer medicine.disease Dysphagia Confidence interval Radiation therapy Oncology 030220 oncology & carcinogenesis Female Radiology medicine.symptom business Deglutition Disorders Cohort study |
| Zdroj: | Practical radiation oncology, 10(4), e255-e263. Elsevier BV Practical Radiation Oncology, 10, E255-E263 Practical Radiation Oncology, 10, 4, pp. E255-E263 |
| ISSN: | 1879-8500 |
| Popis: | Purpose Clinical evidence regarding optimal radiation dose for palliation of dysphagia from esophageal cancer is generally lacking. In an effort to investigate optimal radiation dose, we assessed 2 different radiation schedules for palliation of dysphagia. Methods and Materials We performed a multicenter, retrospective study comparing low-dose radiation therapy (LR: 5 x 4 Gy external beam radiation therapy [EBRT]) with high-dose radiation therapy (HR: 10 x 3 Gy EBRT and 12-Gy single-dose intraluminal brachytherapy) for palliation of dysphagia in patients with inoperable or metastasized esophageal cancer. Primary outcome was improvement of dysphagia at 6 weeks after start of radiation therapy. Additional outcomes were persistent and recurrent dysphagia during patients' remaining life, severe adverse events, and survival. Results In total, 292 patients (LR, n=117; HR, n=175) were included in this study. After matching, 144 patients (72 in each group) were compared. Improvement of dysphagia at 6 weeks was achieved in 50% of patients after LR and in 66% after HR (P = .071). Persistent or recurrent dysphagia occurred in 64% of patients after LR and in 42% after HR (P = .012). No difference in the rate of severe adverse events was found (P = .889). Median survival was 88 days (95% confidence interval, 64-112) after LR and 177 days (95% confidence interval, 131-223) after HR (P Conclusions This study shows that both LR and HR were well tolerated and effective in short-term relief of dysphagia in patients with inoperable or metastasized esophageal cancer. HR was associated with better long-term relief of dysphagia compared with LR. Our findings suggest that HR could be considered for patients with a longer life expectancy, but prospective studies are required. |
| Databáze: | OpenAIRE |
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