TY - JOUR
T1 - External beam radiotherapy combined with intraluminal brachytherapy in esophageal carcinoma
AU - Muijs, Christina T.
AU - Beukema, Jannet C.
AU - Mul, Veronique E.
AU - Plukker, John Th
AU - Sijtsema, Nanna M.
AU - Langendijk, Johannes A.
PY - 2012/2
Y1 - 2012/2
N2 - 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
AB - 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
KW - Esophageal cancer
KW - Radiotherapy
KW - Intraluminal brachytherapy
KW - SQUAMOUS-CELL CARCINOMA
KW - DEFINITIVE RADIATION-THERAPY
KW - DOSE-RATE BRACHYTHERAPY
KW - PROGNOSTIC-FACTORS
KW - RANDOMIZED-TRIAL
KW - COMBINED CHEMORADIOTHERAPY
KW - THORACIC ESOPHAGUS
KW - FOLLOW-UP
KW - CANCER
KW - CHEMOTHERAPY
U2 - 10.1016/j.radonc.2011.07.021
DO - 10.1016/j.radonc.2011.07.021
M3 - Article
VL - 102
SP - 303
EP - 308
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
SN - 0167-8140
IS - 2
ER -