Feasibility of intensity-modulated and image-guided radiotherapy for locally advanced esophageal cancer

Abstract

BackgroundIn this study the feasibility of intensity-modulated radiotherapy (IMRT) and tomotherapy-based image-guided radiotherapy (IGRT) for locally advanced esophageal cancer was assessed.MethodsA retrospective study of ten patients with locally advanced esophageal cancer who underwent concurrent chemotherapy with IMRT (1) and IGRT (9) was conducted. The gross tumor volume was treated to a median dose of 70 Gy (62.4-75 Gy).ResultsAt a median follow-up of 14 months (1-39 months), three patients developed local failures, six patients developed distant metastases, and complications occurred in two patients (1 tracheoesophageal fistula, 1 esophageal stricture requiring repeated dilatations). No patients developed grade 3-4 pneumonitis or cardiac complications.ConclusionsIMRT and IGRT may be effective for the treatment of locally advanced esophageal cancer with acceptable complications.

A novel endoscopic marker for radiological localization and image-guided radiotherapy in esophageal and gastric cancers (with video)

“…However, due to the increased toxicities associated with the higher radiation dose, the application has been limited. 35 The emerging data support the concept of IGRT in the upper GI tract to allow for high-dose radiation with a substantial reduction in side effects that may otherwise be treatment limiting. 35,36 This has been a similar finding across our small subgroup and highlighted by a patient who presented with a bleeding gastric ulcer who proceeded to IGRT in combination with chemotherapy without adverse events and is currently disease free.…”

“…35 The emerging data support the concept of IGRT in the upper GI tract to allow for high-dose radiation with a substantial reduction in side effects that may otherwise be treatment limiting. 35,36 This has been a similar finding across our small subgroup and highlighted by a patient who presented with a bleeding gastric ulcer who proceeded to IGRT in combination with chemotherapy without adverse events and is currently disease free. Without marker placement, he would have proceeded to low-dose palliative radiotherapy to a larger stomach volume with the associated risk of toxicity.…”

Challenges Facing Radiation Oncologists in The Management of Older Cancer Patients: Consensus of The International Geriatric Radiotherapy Group

“…At its inception, IGRG was meant to serve as a forum for radiation oncologists to discuss aging and its impact of aging on patient management. However, after multiple collaborative studies resulting in publications on the potential benefits of image-guided radiotherapy (IGRT) for normal organs sparing and improved local control for various types of cancer, the organization has morphed into a special interest and support group for older cancer patients [15,16,17,18]. Many workshops were organized during international cancer conferences.…”

The Optimal Chinese Herbal Injections for Use With Radiotherapy to Treat Esophageal Cancer: A Systematic Review and Bayesian Network Meta-Analysis

“…Although surgery remains the primary treatment for localized esophageal cancer, the majority of patients recur in regional or distant sites after radical resection, and the overall 5-year survival rate ranges from 15 to 25% (Cappetta et al, 2012; Zhang et al, 2016). An increasing number of patients are diagnosed with esophageal cancer at the advanced stages, and some cases can benefit from radiotherapy to improve overall and progression-free survival as well as locoregional control (Shridhar et al, 2013; Nguyen et al, 2014). However, studies have demonstrated that radiotherapy is often accompanied by serious adverse reaction (ADRs), further impairing the health-related performance status of cancer patients (Beukema et al, 2015).…”