A non-randomized comparison of two radiotherapy protocols in inoperable squamous cell carcinoma of the oesophagus

Datta, Niloy Ranjan; Kumar, Shaleen; Nangia, Sapna; Hukku, S.; Ayyagari, S.

doi:10.1016/s0936-6555(98)80083-6

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…A randomized trial that compared the outcomes of brachytherapy and stent placement found favorable QoL with brachytherapy [17]. More than half of our patients (57.9 %) on follow-up endoscopy showed stricture that was very high compared to the other study from India [18]. Homs et al, in his retrospective analysis, reported complications such as fistula formation and bleeding in 7 % of the patients treated with HDR brachytherapy.…”

Section: Discussionmentioning

confidence: 54%

Palliative Radiotherapy in Esophageal Cancer

et al. 2013

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The present study was undertaken to evaluate the efficacy of radiotherapy in palliation of dysphagia in patients with squamous cell carcinoma (SCC) of esophagus and to see the quality of life (QoL) following radiotherapy. This was a prospective clinical study done between September 2006 and May 2008. All consecutive patients with SCC of the esophagus, who are not candidates for definitive treatment, were included in the study. Dysphagia and QoL were assessed using modified Takita's grading and modified questionnaire based on EORTC QLQ 30 respectively. External beam radiotherapy (EBRT) was delivered to all patients using linear accelerator 6 Mv photons. Patients who had good response with EBRT were further subjected to intraluminal brachytherapy (ILBT) at 700 cGy using Iridium-192. The cumulative dose each patient received was 65 Gy. Patients were followed up at 6 weeks from completion of treatment to look for any difference in dysphagia grade and QoL following therapy. Thirty-three patients were included in the study. The mean age among males and females was 60.9 and 49.8 years, respectively. Nineteen patients (57.6 %) received EBRT followed by ILBT; the remaining patients received only EBRT. Seven were lost during follow-up, and seven (21.2 %) died during the study period of 6 weeks. Nineteen (57.6 %) were followed up. On follow-up endoscopy, evidence of residual stricture was observed in 57.9 %, and growth in 36.8 %. Of the patients, 27.8 % had biopsy-confirmed residual disease. The median dysphagia score decreased from 4 to 3 after treatment (p = 0.002) in 17 (89.5 %) patients. The mean QoL score improved from 107.5 to 114.1 at 6-week follow-up. Following radiotherapy, 26.3 % had persistent chest pain, increased cough with expectoration in 15.8 %, and hyperpigmentation of skin in 10.5 %. Radiotherapy gives significant relief of dysphagia and improves QoL in 90 % of patients with SCC of esophagus. However, following radiotherapy, a number of patients will have persistent stricture, ulceration, and residual disease.

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Section: Discussionmentioning

confidence: 54%

Palliative Radiotherapy in Esophageal Cancer

et al. 2013

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“…The EBRT included in this study were 40 Gy/20#/5#/week with two AP/PA fields for phase 1 and 20 Gy/10#/5#/week with two posterior oblique fields for phase 2. A previous study, which compared two radiotherapy protocols (50 Gy in 25 fractions over 5 weeks and 35 Gy in 15 fractions over 3 weeks) in inoperable SCC of the esophagus showed dysphagia relief in 75% and 49% of patients; and the probability of survival at 1, 2 and 5 years was 35.8% versus 34.8%, 13.9% versus 14.5% and 10% versus 0%, respectively [23]. Several studies have demonstrated the efficacy of chemo-radiotherapy in the treatment of esophageal carcinoma.…”

Section: Discussionmentioning

confidence: 90%

“…A previous study from India that included 125 patients with unresectable SCC of the esophagus, showed 57.6%, 38.9% and 24.8% versus 32.3%, 22.8% and 13.7% OS at 1, 2, and 5 year, for chemo-radiotherapy and radiotherapy alone groups, respectively [24]. Authors concluded that the addition of concurrent cisplatin to radiotherapy can improve survival with manageable acute and late morbidity [23]. Another study by Ruler et al, showed median OS of13.1 months (95% CI 4.7-21.5 months) and a 2-year OS of30% (95% CI 18%-42%) [24].…”

Section: Discussionmentioning

confidence: 96%

Efficacy of chemo-radiotherapy versus radiotherapy alone in the treatment of esophageal carcinoma

Kumar

Yadav

et al. 2019

Int J Med Res Rev

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Background: The treatment of esophageal carcinoma may demand multiple approaches including combination of radiotherapy and chemotherapy, particularly cases which are considered unresectable, such as upper third esophageal cancers, locally advanced middle and lower third cancers. Methods: This was a prospective, randomized, open-label, single-center study conducted between December 2014 and July 2016. Patients of either sex aged more than 18 years with the confirmed diagnosis of previously untreated advanced esophageal carcinoma were included in the study. Eligible patients were randomized to receive one of the treatments (chemo-radiotherapy [cisplatin] or radiotherapy alone). Response criteria included dysphasia free survival (DySF), disease free survival (DFS), and overall survival (OS). Tolerability was also assessed. Results: A total of 31 patients (chemo-radiotherapy, n=13; radiotherapy alone, n=18) were enrolled in this study. At one year, the probability of remaining dysphagia free was 40% and 20%, respectively for chemo-radiotherapy and radiotherapy alone groups; and the probability of OS was 64% versus 21%, respectively. The median DFS was 12 months and 5 months for chemo-radiotherapy and radiotherapy alone group, respectively. There were no significant differences in both the groups in EBRT, total treatment duration and duration of EBRT. No patient reported thrombocytopenia or nephrotoxicity. Conclusions: Concurrent chemo-radiotherapy with cisplatin can improve dysphasia and OS in patients with esophageal carcinoma.

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“…Some authors [30] recommend not going beyond 20 Gy, as an increase of bleeding and stenosis will be produced from that dose on. Some other authors [31] think 12 Gy is the optimum dose to obtain the maximum response with the minimum complications.…”

Section: Discussionmentioning

confidence: 97%