Significant adbantage of chemo-radiotherapy compared to radiation alone in randomized phase III trial for patients with esophageal cancer: An intergroup study

Herskovic, Arnold; Pajak, Thomas F.; Al‐Sarraf, Muhyi; Leidman, Lawrence; Brindle, Jeffrey; Vaitkevicius, Vainutis K.; Cooper, Jay S.; Byhardt, R.; Davis, Lawrence W.; Emami, Bahman

doi:10.1016/0360-3016(91)90570-t

Cited by 10 publications

(2 citation statements)

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“…Boluses were administered from a teaspoon or by slow release from a syringe. Fluoroscopic data were recorded on a 3 4 -inch videotape at 30 frames per second. During the study, the fluoroscopy tube was focused on the lips anteriorly, the cervical vertebrae posteriorly, the soft palate superiorly, and the bifurcation of the esophagus and airway inferiorly.…”

Section: Methodsmentioning

confidence: 99%

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Tissue/dose compensation to reduce toxicity from combined radiation and chemotherapy for advanced head and neck cancers

et al. 2001

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SUMMARY This study was undertaken to quantify the reduction in normal tissuecomplications resulting from the aggressive management of advanced head and neck cancers (AHNCs) utilizing tissue/dose compensation (TDC). Thirty-nine patients with AHNC were treated on an intensive chemotherapy ؉ radiation regimen. Eighteen of 39 patients were treated using TDC; the remaining 21 patients were radiated without TDC (NTDC). Acute and chronic toxicities, swallowing, speech function, and quality of life were assessed. The TDC group had a smaller radiation dose gradient across the entire treatment volume. Unscheduled treatment breaks were required in 11% of TDC patients as compared with 43% of the NTDC group (P ‫؍‬ 0.04). The TDC group had fewer Grade 3 or 4 acute and chronic toxicities and lower SOMA scores. At 3 months posttreatment, patients in the TDC group had better oral intake, lower pharyngeal residue, and better oropharyngeal swallowing efficiency and were able to swallow more bolus types. Patients in the TDC group also had better articulation. Use of TDC resulted in reduced treatmentrelated interruptions, decreased acute and chronic toxicities, and better speech and swallowing functions. Techniques to improve radiation dose conformality around the target tissues while decreasing the radiation dose to the normal tissues should be an integral part of aggressive combined modality therapy.

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Section: Methodsmentioning

confidence: 99%

“…Over the last decade, the intensity of therapy using chemotherapy and radiation has increased, resulting in decreased locoregional failure and improved survival [2][3][4][5][6][7]. Due to the aggressive nature of these treatments, toxicities have also increased.…”

Section: Introductionmentioning

confidence: 99%

Tissue/dose compensation to reduce toxicity from combined radiation and chemotherapy for advanced head and neck cancers

et al. 2001

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Swallowing function in patients with esophageal cancer treated with concurrent radiation and chemotherapy

Coia

Soffen

Schultheiss

et al. 1993

Cancer

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Background. Major goals of concurrent radiation and chemotherapy in the treatment of esophageal cancer are the early restoration and long‐term maintenance of swallowing function. The purpose of this study was to determine the impact of concurrent radiation and chemotherapy on swallowing function. Methods. Between September 1980 and September 1990, 120 patients with esophageal cancer were treated at the Fox Chase Cancer Center on the basis of one of three prospective nonrandomized protocols using concurrent chemotherapy and radiation. Swallowing function was retrospectively assessed in these patients by use of a swallowing‐function scoring system. In addition, patients who had long‐term control of their esophageal cancer underwent a more detailed analysis of swallowing function. Results. Initial improvement in dysphagia occurred in 88% of the 102 assessable patients, with a median time to improvement of 2 weeks. There was no difference in overall percentage of initial improvement for patients with adenocarcinoma versus squamous cell carcinoma. Patients with distal tumors, however, showed both earlier and higher frequency of initial improvement than did patients with tumors in the upper two‐thirds of the thoracic esophagus (95% versus 79%). Local relapse‐free survival of definitively treated patients at 3 years was 60% and was significantly better for patients with Stage I (76%) versus Stage II cancers (55%) (P < 0.05). All 25 patients treated with curative intent who survived for more than 1 year without evidence of disease were able to eat soft or solid foods and had a benign stricture rate of only 12%. Even in patients with advanced disease who were treated with palliative intent, 91% had an initial improvement in swallowing function and 67% had improvement in swallowing function that lasted until death. Conclusions. High‐dose concurrent radiation and chemotherapy provides rapid improvement in dysphagia, and this improvement results in normal or near‐normal swallowing function of long duration.

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Combined chemotherapy and radiotherapy (without surgery) compared with radiotherapy alone in localized carcinoma of the esophagus

Rebecca¹,

Richard²

2003

Cochrane Database of Systematic Reviews

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Significant adbantage of chemo-radiotherapy compared to radiation alone in randomized phase III trial for patients with esophageal cancer: An intergroup study

Cited by 10 publications

References 0 publications

Tissue/dose compensation to reduce toxicity from combined radiation and chemotherapy for advanced head and neck cancers

Tissue/dose compensation to reduce toxicity from combined radiation and chemotherapy for advanced head and neck cancers

Swallowing function in patients with esophageal cancer treated with concurrent radiation and chemotherapy

Combined chemotherapy and radiotherapy (without surgery) compared with radiotherapy alone in localized carcinoma of the esophagus

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