Results of External Irradiation and Low-Dose-Rate Intraluminal Brachytherapy for Esophageal Cancer

Someya, Masanori; Sakata, Koh‐ichi; Saitô, Akio; Nagakura, Hisayasu; Oouchi, Atsushi; Hareyama, Masato

doi:10.1080/028418602317314082

Cited by 11 publications

(7 citation statements)

References 16 publications

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“…Advanced stages of esophageal cancer have been treated with EBRT + EBT, with 2-year survival rates ranging between 17% and 34%, and from 10% to 28% at 5 years. Table 2 presents the most relevant series of EBRT + EBT for advanced cases, with late complication rates for ulcerations of 3-11%, 8-16% for stenosis, 9% for fistula, and 5% for fatal hemorrhage [21,[39][40][41][42][43][44][45]. These complications, especially the latter two, may also appear in patients with tumor reduction after chemotherapy and EBRT, or in tumor progression.…”

Section: Ebrt + Ebt In Advanced Tumorsmentioning

confidence: 99%

“…These complications, especially the latter two, may also appear in patients with tumor reduction after chemotherapy and EBRT, or in tumor progression. The lack of benefit in increasing overall survival can be explained by the heterogeneity of these tumors and high probability of distant metastasis, although an increase in local control has been described by Someya et al in tumors < 5 cm compared with tumors ≥ 5 cm [43]. Studies evaluating local control, dysphagia-free time, and quality of life are needed.…”

Section: Ebrt + Ebt In Advanced Tumorsmentioning

confidence: 99%

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Why is a very easy, useful, old technique underused? An overview of esophageal brachytherapy – interventional radiotherapy

Rovirosa¹,

Tagliaferri²,

Chicheł³

et al. 2022

jcb

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Endoesophageal brachytherapy (EBT) or endoesofageal interventional radiotherapy (EIRT) is an effective technique that has been used with varying frequency for many years. It is a very good technique in T1-T2 inoperable esophageal cancer and in the palliation of dysphagia. However, only some centers have access to this technique, and consequently, it is underused. Here, we discussed the indications and several technical aspects as well as the literature available. Also, why this technique is underused and how this can be overcome. We consider that EBT is a very effective technique that should be used whenever indicated.

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Section: Ebrt + Ebt In Advanced Tumorsmentioning

confidence: 99%

Section: Ebrt + Ebt In Advanced Tumorsmentioning

confidence: 99%

Why is a very easy, useful, old technique underused? An overview of esophageal brachytherapy – interventional radiotherapy

Rovirosa¹,

Tagliaferri²,

Chicheł³

et al. 2022

jcb

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“…The reference point for dose calculation was a point at a distance of 5 mm from the applicator axis. ILBT was delivered with a fractional dose of 3.5-4.0 Gy, given once per week at a total dose of 7-18 Gy [12] (Table 1).…”

Section: Radiotherapymentioning

confidence: 99%

Influence of XRCC4 expression in esophageal cancer cells on the response to radiotherapy

et al. 2016

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DNA double-strand break (DSB) is one of the most serious forms of damage induced by ionizing irradiation and is mainly repaired by the non-homologous end joining (NHEJ) repair. Immunohistochemical analysis of proteins involved in NHEJ, such as XRCC4 (X-ray repair cross-complementing protein 4), Ku86 and DNA-PKcs (DNA-dependent protein kinase, catalytic subunits), may be useful for predicting tumor radiosensitivity. We examined 92 patients with esophageal squamous cell carcinoma (ECSS) who were treated by radiotherapy between 1999 and 2008. Immunohistochemical examination of tumor tissue for Ki-67 and DSB-related proteins, including XRCC4, Ku86, and DNA-PKcs, was performed using pretreatment biopsy specimens. Low expression of XRCC4 was detected in 31 of 92 examined samples (33.7 %). The 5-year overall survival (OS) rate was 67.7 % in the low expression group and 31.0 % in the high expression group (P = 0.00). Multivariate analysis confirmed that advanced T-stage (HR 3.24, P = 0.01), radiation dose less than 66 Gy (HR 2.23, P = 0.02), absence of systemic chemotherapy (HR 2.59, P = 0.05), and high expression of XRCC4 (HR 12.0, P = 0.02) were independent prognostic factors for predicting poor OS. Other DSB-related proteins and Ki-67 were not predictive factors. XRCC4 expression might have an influence on results of radiotherapy for patients with ESCC.

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“…Someya M. in their study observe that In patients with tumours of 5 cm or less in length, the results of treatment with 60 Gy ERT and 20 Gy ILBT were promising and did not cause severe late complications, in tune with present study. [29] In the multi-institutional analysis a slightly higher 2-year local control rate was obtained in the group that received external beam RT with ILBT (90%) than in the group that received external beam radiotherapy alone with superficial oesophageal carcinoma (77%). [30] In a study conducted in patients with T1 and T2 tumours, found that the brachytherapy group showed a trend (p = 0.088) toward better overall survival and a significant survival benefit in those with tumours smaller than 5 cm (p = 0.025).…”

Section: The Advantage Of Brachytherapy Over Ebrt Ismentioning

confidence: 89%

Radical External Beam Radiotherapy With Intraluminal High Rate Dose Brachytherapy In Patients With Carcinoma Esophagus

Chauhan¹,

Kaur²,

Annex³

2009

IJGE

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Aims: -Oesophageal carcinoma is an uncommon malignancy, accounting for approximately 1% of all malignancy and 6% of all gastrointestinal malignancies, patients with carcinoma oesophagus usually present with advanced disease. A combination of external and intraluminal radiation therapy is useful to palliate these patients. We report the findings of a retrospective study done on patients with carcinoma oesophagus who were treated withExternal radiationtherapy Followed by Intraluminal brachytherapy.Methods-21 patients who received ILBT followed by EBRT in year 2006-7, of unresectable carcinoma oesophagus without any history of previous anticancer treatment were given external radiotherapy, 40 Gy in 20 fractions over 4 weeks. After gap of two to three week all patients were given Intraluminal high dose rate brachytherapy (5 cGy /3fr/one week apart) were enrolled for this retrospective study. After completion of treatment patients were evaluated every moths for clinical response, toxicity and survival. Results-Majority of patients were ranged 48-66, with median age of presentation was 57 years. 20 (95%) were male and 1(5%) was female patient. Dysphagia free survival was seen in 20 (95%) of patients. Recurrence was seen in one (5%) patient after completion of four months of follow up. Complete response seen in 19 patients (90.4%) at the completion of treatment. Two patients (9.52%) showed persistent disease. Conclusions-The use of HDR-ILBRT, as a treatment for unresectable oesophageal cancer, was significantly effective and HDR-ILBRT contributed to improve outcomes, as well as symptoms free survival in patients with advanced oesophageal cancer. Oesophageal stricture is a common late toxicity in IBT for oesophageal carcinoma. Late complications, including oesophageal ulcer and fistula, were not seen in the present study.

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Results of External Irradiation and Low-Dose-Rate Intraluminal Brachytherapy for Esophageal Cancer

Cited by 11 publications

References 16 publications

Why is a very easy, useful, old technique underused? An overview of esophageal brachytherapy – interventional radiotherapy

Why is a very easy, useful, old technique underused? An overview of esophageal brachytherapy – interventional radiotherapy

Influence of XRCC4 expression in esophageal cancer cells on the response to radiotherapy

Radical External Beam Radiotherapy With Intraluminal High Rate Dose Brachytherapy In Patients With Carcinoma Esophagus

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