Title: Comparative Study of two High Dose Rate Intraluminal Brachytherapy Schedules in Locally Advanced (Unresectable) CA Esophagus
Authors: Dr Ranjeet Ram Jat, Dr Neeti Sharma, Dr H.S. Kumar, Dr S.L. Jakhar, Dr Pukhraj Sadh
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.05
Abstract
Purpose of the study was to assess local tumor control and overall survival, diffirence in acute toxicities, and dysphagia free survival among two HDR intraluminal brachytherapy schedules for unresectable esophageal cancer. A total of 50 patients of locally advanced unresectable ca esophagus were taken for the study from January 2018 to February 2019. All patients were histological proven cases. All 50 patients were treated with CTRT (EBRT 44 Gy/22#, 2Gy/#, 1#/day, 5 days a week + weekly CT (cisplatin 40 mg/m2). Then followed by 2-3 weeks of gap 25 patients of this 50 were randomized on one to one basis to each Arm (Arm A and B). In arm A (6Gy/# total 2#, biweekly schedule) and arm B (4Gy/# total 3#, biweekly schedule).
All patients tolerated treatment well, no major adverse effects were monitored in two groups. There was no significant statistical difference in treatment response, which was found 84% vs 88% in 6Gy arm and 4Gy arm respectively .however toxicity profile, was slightly higher in 6Gy arm. The 6 months DyFS were 52% and 68% in 6Gy arm and 4Gy arm respectively;( p value>.05).Overall survival were slightly higher in 4Gy arm in compare to 6Gy arm (96%vs92%).
Keywords: Intraluminal brachytherapy, high dose rate, dysphagia free survival ,locally advanced carcinoma esophagus.
References
- Esophageal cancer: epidemiology, pathogenesis and prevention. Nat Clin Pract Gastroenterol Hepatol 2008; 5: 517-526 [PMID: 18679388 DOI: 10.1038/ncpgasthep1223])
- Hareyama M, Nishio M, Kagami Y, Narimatsu N, Saito A, Sakurai T. Intracavitary brachytherapy combined with external beam irradiation for squamous cell carcinoma of the thoracic esophagus. Int J Radiat Oncol Biol Phys 1992;24:235-40.
- Sun De-Ren. Ten year follow up of esophageal cancer treated by radical radiation therapy: Analysis of 869 patients. Int J Radiat Oncol Biol Phys 1989;16:329-34.
- Vauthey JN, Maddern GJ, Gertsch P. Cesar Roux – Swiss pioneer in surgery Surgery. 1992; 112:946–50.
- Gaspar LE, Winter K, Kocha WI et al. A phase I/II study of external beam radiation, brachytherapy, and concurrent chemotherapy for patients with localized carcinoma of the esophagus (Radiation Therapy Oncology Group Study 9207): final report. Cancer 2000; 88: 988-995
- Calais G, Dorval E, Louisot P, Bourlier P, Klein V, Chapet S, et al. Radiotherapy with high dose rate brachytherapy boost and concomitant chemotherapy for stages IIB and III esophageal carcinoma: Results of a pilot study. Int J Radiat Oncol Biol Phys 1997;38:769-75.
- Kapoor R, Bansal A, Kochhar R, Kumar P, Sharma SC. Effectiveness of two high-dose-rate intraluminal brachytherapy schedules for symptom palliation in carcinoma esophagus: A tertiary care center experience. Indian J Palliat Care 2012;18:34-9.