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ORIGINAL ARTICLE
Year : 2014  |  Volume : 10  |  Issue : 2  |  Page : 337-341

Treatment outcomes after intraluminal brachytherapy following definitive chemoradiotherapy in patients with esophageal cancer


1 Department of Radiotherapy, Shirdi Saibaba Cancer Hospital and Research Centre, Manipal, Karnataka, India
2 Department of Community Medicine, Manipal College of Medical Sciences, Pokhara, Nepal, India

Correspondence Address:
Sourjya Banerjee
Department of Radiotherapy and Oncology, Shirdi Saibaba Cancer Hospital and Research Centre, Manipal, Karnataka-576 104
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.136623

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Aims and Objectives: To report the results of treatment with intraluminal brachytherapy (ILRT) after concurrent chemoradiotherapy for esophageal carcinoma with respect to disease free survival (DFS), dysphagia free interval (DFI), and complications of treatment. Materials and Methods: The study retrospectively analyzed the records of 26 eligible patients with nonmetastatic carcinoma of the esophagus treated with definitive chemoradiotherapy followed by ILRT between 2008 and 2011. The DFS and DFI were estimated and factors likely to influence them were analyzed. Results: Nineteen (73%) patients were males. The mean age at presentation was 60 years (range: 47-90 years). All the patients had squamous cell carcinomas. Following treatment, the median DFS was 12.7 months (range: 0-27 months). Sixteen patients (61.5%) had local control of their disease, while one had residual disease at completion of treatment. Other than three patients who were not evaluated for recurrent dysphagia, six (23.1%) had proven local recurrence on follow-up. The estimated mean DFI was 13.8 months (range: 0-27 months). One patient died of tracheoesophageal fistula following treatment. On statistical analysis, only the location of tumor was prognostically significant, with lower third tumors performing worse. Other probable predictors of poor outcome included large volume (> 40 cc), tumor length (> 6 cm), and eccentric location. Conclusion: ILRT boost following concurrent chemoradiotherapy is well tolerated and potentially improves outcomes. It might be beneficial in selected patients with esophageal carcinoma. Further studies are required to identify its role in definitive treatment.

Abstract in Chinese

食管癌患者放化疗后行腔内近距离放疗疗效评价 摘要 目的:研究食管癌同步放化疗后腔内放疗(ILRT)对无病生存期(DFS),吞咽困难的时间间隔(DFI),以及治疗并发症的影响。 材料与方法:本研究回顾性分析2008和2011年间26例符合条件的患者,他们均为非转移性食管癌,在同步放化疗后进行了腔内放疗(ILRT)。对DFS和DFI及可能的影响因素进行了分析。 结果:19例(73%)为男性。发病时的平均年龄在60岁(范围:47~90岁)。所有的病人都为鳞状细胞癌。治疗后,中位DFS 12.7个月(0~27个月)。16例患者(61.5%)得到局部控制,其中1例治疗结束后仍有残留病灶。除3例未进行复发性吞咽困难的评估,其余16例患者中6例(23.1%)局部复发,平均DFI约在 13.8个月(范围:0~27个月)。一例病人死于食管气管瘘的治疗。统计分析结果表明,肿瘤部位与肿瘤位置对预后有显著影响:体积>40 CC、肿瘤直径>6cm、肿瘤位于食管下1/3段的患者预后较差。 结论:同步放化疗后的ILRT耐受性良好,并可能改善预后。这可能有利于特定的食管癌病人。需要进一步的研究来确定其在放疗治疗方案中的作用。 关键词:同步放化疗,食管癌,腔内近距离放疗



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