Long-term outcomes of intraluminal brachytherapy in combination with external beam radiotherapy for superficial esophageal cancer

Murakami, Yuji; Nagata, Yasushi; Nishibuchi, Ikuno; Kimura, Tomoki; Kenjo, Masahiro; Kaneyasu, Yuko; Okabe, Takao; Hashimoto, Yasutoshi; Akagi, Yukio

doi:10.1007/s10147-011-0285-4

Cited by 26 publications

(19 citation statements)

References 29 publications

(45 reference statements)

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“…Although previous reports showed RT alone was inferior to CRT in esophageal cancer, we did not observe a significant difference in OS between CRT and RT alone [12,14,19,20]. We previously reported the long-term outcome of IBT in combination with EBRT for superficial esophageal cancer [11]. In that report, the most common failure pattern was the primary site, and regional lymph node metastasis tended to occur more frequently in submucosal cases.…”

Section: Discussioncontrasting

confidence: 66%

“…Until 2002, our institution commonly performed intraluminal brachytherapy (IBT) combined with external beam radiotherapy (EBRT) for the treatment of superficial esophageal cancer. We previously reported the long-term treatment results in patients with superficial esophageal cancer who received this treatment [11]. Favorable treatment outcomes in mucosal cancer were achieved in that study.…”

Section: Introductionmentioning

confidence: 89%

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Effectiveness of salvage radiotherapy for superficial esophageal Cancer after non-curative endoscopic resection

et al. 2020

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Background: Endoscopic resection is widely used as an effective treatment for superficial esophageal cancer. However, the risk of lymph node metastasis increases in cases of muscularis mucosae or deeper invasion, for which additional treatment such as radiotherapy or surgery is required. Accordingly, the current study investigated the efficacy and toxicity of salvage radiotherapy after non-curative endoscopic resection as an organ preservation strategy. Methods: We retrospectively reviewed 37 esophageal cancer patients who received salvage radiotherapy after noncurative endoscopic resection. The pathological invasion depths were the muscularis mucosae, submucosal layer, and muscularis propria in 14, 22, and one patient, respectively. All patients received external beam radiotherapy. Among them, eight received intraluminal brachytherapy following external beam radiotherapy. Elective nodal irradiation was administered to all patients. Twenty-five patients received concurrent platinum and fluorouracilbased chemotherapy. Results: The median follow-up time was 74 months (range: 3-212). The 5-year progression-free survival and overall survival rates were 64 and 78%, respectively. No local or regional lymph node recurrence was observed. The causes of death included esophageal cancer in one patient, metachronous esophageal cancer in one patient, other malignancies in eight patients, and other causes in six patients. Late cardiac toxicities ≥ grade 3 were observed in six patients, one of whom died of arrhythmia.Conclusions: Salvage radiotherapy after non-curative esophageal endoscopic resection is an effective treatment as an organ preservation strategy. Although muscularis mucosae and submucosal cancer have a high risk of lymph node metastasis, our results suggest that elective nodal irradiation contributes to reduced regional node metastases.

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Section: Discussioncontrasting

confidence: 66%

Section: Introductionmentioning

confidence: 89%

Effectiveness of salvage radiotherapy for superficial esophageal Cancer after non-curative endoscopic resection

et al. 2020

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“…There was a clear difference in the treatment results depending on the level of tumor invasion; the tumor depth was a significant factor for the overall survival (12). A recent study revealed the correlation between the rate of lymph node metastasis and the depth of the tumor invasion of superficial esophageal cancers.…”

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confidence: 99%

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

et al. 2015

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Objective The standard treatment for submucosal esophageal cancer is esophagectomy or chemoradiotherapy (CRT). However, these treatment modalities could deteriorate the general condition and quality of life of the patients who are intolerant to invasive therapy. It is therefore important and beneficial to develop less invasive treatment protocols for these patients. Methods The study included 43 patients who were clinically suspected of mucosa or submucosal esophageal cancer but underwent endoscopic submucosal dissection (ESD) as a primary treatment, due to the patients' poor performance statuses and/or preferences for less invasive therapy. According to the pathological findings and patient's general condition, whether the patient underwent additional treatments or remained hospitalized without additional treatments was thereafter decided for each patient. We retrospectively analyzed the outcomes of these patients. Results Fifteen patients underwent additional surgery, 11 patients underwent CRT/radiation therapy (RT) and 17 patients were followed without additional treatments. During the 3-year follow-up period, the relapsefree survival rates in the patients who received or did not receive additional treatments were 88% and 64%, respectively (95% confidence interval, 0.45-0.76, p=0.04). The relapse-free and overall survival rates in the patients with additional treatments were equivalent or superior to those described in previous reports of the standard treatments. Preceding ESD contributed to reduce the local relapse significantly to approximately 3.5% and additional CRT-related toxicities. Conclusion Preceding ESD is very effective for the local control of cancer, and useful for histologically confirming the high-risk factors of relapse, such as ! submucosal layer 2 (SM2) invasion and lymphovascular involvements. ESD with additional therapy may be a promising strategy for optimizing the selection of therapy depending on the patient's general condition.

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“…The treatment field and dose of external radiotherapy show variation (13). Additionally, administrations of chemotherapy were different and some studies included data on patients treated with endoluminal brachytherapy or endoscopic submucosal dissection (10)(11)(12)(13). Most of these series involved patients primarily with SCC.…”

Section: Discussionmentioning

confidence: 99%

The Importance of Concurrent Chemotherapy for T1 Esophageal Cancer: Role of FDG-PET/CT for Local Control

Ogino

Watanabe

Hirasawa

et al. 2018

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Long-term outcomes of intraluminal brachytherapy in combination with external beam radiotherapy for superficial esophageal cancer

Abstract: There was a clear difference in outcomes of IBT combined with EBRT between mucosal and submucosal esophageal cancers. More intensive treatment should be considered for submucosal cancer.

Cited by 26 publications

References 29 publications

Effectiveness of salvage radiotherapy for superficial esophageal Cancer after non-curative endoscopic resection

Effectiveness of salvage radiotherapy for superficial esophageal Cancer after non-curative endoscopic resection

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

The Importance of Concurrent Chemotherapy for T1 Esophageal Cancer: Role of FDG-PET/CT for Local Control

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