External beam radiation therapy followed by high-dose-rate brachytherapy for inoperable superficial esophageal carcinoma

Journal Article · Tue Aug 01 04:00:00 EDT 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.02.049· OSTI ID:20850028

Pasquier, David ^[1]; Mirabel, Xavier ^[1]; Adenis, Antoine ^[2]; Rezvoy, Nicolas ^[1]; Hecquet, Genevieve ^[2]; Fournier, Charles ^[3]; Coche-Dequeant, Bernard ^[1]; Prevost, Bernard ^[1]; Castelain, Bernard ^[1]; Lartigau, Eric ^[1]

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1. Department of Radiotherapy, Centre Oscar Lambret, University Lille II, Lille (France)
2. Department of Digestive and Urological Cancer, Centre Oscar Lambret, Lille (France)
3. Biostatistics Unit, Centre Oscar Lambret, Lille (France)

Purpose: The aim of this study was to retrospectively evaluate the feasibility, efficacy, and tolerance of external beam radiotherapy followed by high-dose-rate brachytherapy in inoperable patients with superficial esophageal cancer. Patients and Methods: From November 1992 to May 1999, 66 patients with superficial esophageal cancer were treated with exclusive radiotherapy. The median age was 60 years (range, 41-85). Fifty-three percent of them were ineligible for surgery owing to synchronous or previously treated head-and-neck cancer. Most of the patients (n = 49) were evaluated with endoscopic ultrasonography (EUS) or computed tomography (CT). The mean doses of external beam radiotherapy and high-dose rate brachytherapy were 57.1 Gy ({+-}4.83) and 8.82 Gy ({+-}3.98), respectively. The most frequently used regimen was 60 Gy followed by 7 Gy at 5 mm depth in two applications. Results: Among patients evaluated with EUS or CT, the complete response rate was 98%. The 3-, 5-, and 7-year survival rates were 57.9%, 35.6%, and 26.6%, respectively. Median overall survival was 3.8 years. The 5-year relapse-free survival and cause-specific survival were 54.6% and 76.9%. The 5-year overall, relapse-free, and cause-specific survival of the whole population of 66 patients was 33%, 53%, and 77%, respectively. Local failure occurred in 15 of 66 patients; 6 were treated with brachytherapy. Severe late toxicity (mostly esophageal stenosis) rated according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scale occurred in 6 of 66 patients (9%). Conclusion: This well tolerated regimen may be a therapeutic alternative for inoperable patients with superficial esophageal cancer. Only a randomized study could be able to check the potential benefit of brachytherapy after external beam radiation in superficial esophageal cancer.

• OSTI ID: 20850028
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 65; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
CARCINOMAS
COMPUTERIZED TOMOGRAPHY
DOSE RATES
FAILURES
HEAD
NECK
PATIENTS
RADIATION DOSES
SURGERY
TOLERANCE
TOXICITY
ULTRASONOGRAPHY