Single-Dose Brachytherapy for the Palliative Treatment of Esophageal Cancer

 

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Brachytherapy (intraluminal radiotherapy) has been in use for more than two decades as a boost after external beam radiation for the definitive treatment of esophageal carcinoma. Recent studies have suggested that brachytherapy alone could be a promising therapy for the palliation of dysphagia caused by inoperable esophageal carcinoma. Single-dose brachytherapy has been shown to be not only more effective but also a safer palliative treatment for dysphagia than stent placement, which is currently the most widely used palliative treatment for esophageal cancer, and the wider use of brachytherapy in this setting is therefore warranted.

References

• 1 Parkin D M, Bray F I, Devesa S S. Cancer burden in the year 2000: the global picture.  Eur J Cancer. 2001;  37 (Suppl 8) 4-66
  PubMedGoogle Scholar
• 2 Botterweck A A, Schouten L J, Volovics A. et al . Trends in incidence of adenocarcinoma of the oesophagus and gastric cardia in ten European countries.  Int J Epidemiol. 2000;  29 645-654
  CrossrefPubMedGoogle Scholar
• 3 Devesa S S, Blot W J, Fraumeni J F Jr. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States.  Cancer. 1998;  83 2049-2053
  CrossrefPubMedGoogle Scholar
• 4 Pisani P, Parkin D M, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990.  Int J Cancer. 1999;  83 18-29
  PubMedGoogle Scholar
• 5 Sundelof M, Ye W, Dickman P W, Lagergren J. Improved survival in both histologic types of oesophageal cancer in Sweden.  Int J Cancer. 2002;  99 751-754
  CrossrefPubMedGoogle Scholar
• 6 Medical Research Councel Oesophageal Cancer Working Group . Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial.  Lancet. 2002;  359 1727-1733
  CrossrefPubMedGoogle Scholar
• 7 Malthaner R, Fenlon D. Preoperative chemotherapy for resectable thoracic esophageal cancer.  Cochrane Database Syst Rev. 2001;  4 CD001556
  PubMedGoogle Scholar
• 8 Geh J I. The use of chemoradiotherapy in oesophageal cancer.  Eur J Cancer. 2002;  38 300-313
  CrossrefPubMedGoogle Scholar
• 9 Arnott S J, Duncan W, Gignoux M. et al . Preoperative radiotherapy for esophageal carcinoma.  Cochrane Database Syst Rev. 2000;  2 CD001799
  PubMedGoogle Scholar
• 10 Stuschke M, Stahl M, Wilke H. et al . Induction chemotherapy followed by concurrent chemotherapy and high-dose radiotherapy for locally advanced squamous cell carcinoma of the upper-thoracic and midthoracic esophagus.  Am J Clin Oncol. 2000;  23 233-238
  PubMedGoogle Scholar
• 11 Ohtsu A, Boku N, Muro K. et al . Definitive chemoradiotherapy for T4 and/or M1 lymph node squamous cell carcinoma of the esophagus.  J Clin Oncol. 1999;  17 2915-2921
  PubMedGoogle Scholar
• 12 Schraube P, Fritz P, Wannenmacher M F. Combined endoluminal and external irradiation of inoperable oesophageal carcinoma.  Radiother Oncol. 1997;  44 45-51
  CrossrefPubMedGoogle Scholar
• 13 Taal B G, Aleman B M, Koning C C, Boot H. High dose rate brachytherapy before external beam irradiation in inoperable oesophageal cancer.  Br J Cancer. 1996;  74 1452-1457
  CrossrefPubMedGoogle Scholar
• 14 Siersema P D, Hop W C, van Blankenstein M. et al . A comparison of three types of covered metal stents for the palliation of patients with dysphagia caused by esophagogastric carcinoma: a prospective, randomized study.  Gastrointest Endosc. 2001;  54 145-153
  CrossrefPubMedGoogle Scholar
• 15 Christie N A, Buenaventura P O, Fernando H C. et al . Results of expandable metal stents for malignant esophageal obstruction in 100 patients: short-term and long-term follow-up [and Discussion].  Ann Thorac Surg. 2001;  71 1797-1802
  CrossrefPubMedGoogle Scholar
• 16 Kozarek R A, Raltz S, Brugge W R. et al . Prospective multicenter trial of esophageal Z-stent placement for malignant dysphagia and tracheoesophageal fistula.  Gastrointest Endosc. 1996;  44 562-567
  PubMedGoogle Scholar
• 17 Hishikawa Y, Kurisu K, Taniguchi M. et al . High-dose-rate intraluminal brachytherapy for esophageal cancer: 10 years experience in Hyogo College of Medicine.  Radiother Oncol. 1991;  21 107-114
  CrossrefPubMedGoogle Scholar
• 18 Gaspar L E, Nag S, Herskovic A. et al . American Brachytherapy Society (ABS) consensus guidelines for brachytherapy of esophageal cancer. Clinical Research Committee, American Brachytherapy Society, Philadelphia, PA.  Int J Radiat Oncol Biol Phys. 1997;  38 127-132
  CrossrefPubMedGoogle Scholar
• 19 Rowland C G, Pagliero K M. Intracavitary irradiation in palliation of carcinoma of oesophagus and cardia.  Lancet. 1985;  2 981-983
  PubMedGoogle Scholar
• 20 Brewster A E, Davidson S E, Makin W P. et al . Intraluminal brachytherapy using the high dose rate microSelectron in the palliation of carcinoma of the oesophagus.  Clin Oncol (R Coll Radiol). 1995;  7 102-105
  CrossrefPubMedGoogle Scholar
• 21 Jager J, Langendijk H, Pannebakker M. et al . A single session of intraluminal brachytherapy in palliation of oesophageal cancer.  Radiother Oncol. 1995;  37 237-240
  CrossrefPubMedGoogle Scholar
• 22 Kulhavy M, Sur R K, Levin C V. et al . Optimization of single-fraction high dose rate intraluminal brachytherapy in palliation of advanced esophageal cancer: a preliminary report.  Endocurie Hypertherm Oncol. 1995;  11 235-239
  PubMedGoogle Scholar
• 23 Sur R K, Donde B, Levin V C, Mannell A. Fractionated high dose rate intraluminal brachytherapy in palliation of advanced esophageal cancer.  Int J Radiat Oncol Biol Phys. 1998;  40 447-453
  CrossrefPubMedGoogle Scholar
• 24 Sur R K, Levin C V, Donde B. et al . Prospective randomized trial of HDR brachytherapy as a sole modality in palliation of advanced esophageal carcinoma: an International Atomic Energy Agency study.  Int J Radiat Oncol Biol Phys. 2002;  53 127-133
  CrossrefPubMedGoogle Scholar
• 25 Sharma V, Mahantshetty U, Dinshaw K A. et al . Palliation of advanced/recurrent esophageal carcinoma with high-dose-rate brachytherapy.  Int J Radiat Oncol Biol Phys. 2002;  52 310-315
  CrossrefPubMedGoogle Scholar
• 26 Homs M Y, Eijkenboom W M, Coen V L. et al . High dose rate brachytherapy for the palliation of malignant dysphagia.  Radiother Oncol. 2003;  66 327-332
  CrossrefPubMedGoogle Scholar
• 27 Homs M Y, Steyerberg E W, Eijkenboom W M. et al . Single-dose brachytherapy versus metal stent placement for the palliation of dysphagia from oesophageal cancer: multicentre randomised trial.  Lancet. 2004;  364 1497-1504
  CrossrefPubMedGoogle Scholar
• 28 Nickers P, Kunkler I, Scalliet P. Modern brachytherapy: current state and future prospects.  Eur J Cancer. 1997;  33 1747-1751
  CrossrefPubMedGoogle Scholar
• 29 Sur R, Donde B, Falkson C. et al . Randomized prospective study comparing high-dose-rate intraluminal brachytherapy (HDRILBT) alone with HDRILBT and external beam radiotherapy in the palliation of advanced esophageal cancer.  Brachytherapy. 2004;  3 191-195
  CrossrefPubMedGoogle Scholar
• 30 Sur R K, Kochhar R, Singh D P. Oral sucralfate in acute radiation oesophagitis.  Acta Oncol. 1994;  33 61-63
  PubMedGoogle Scholar
• 31 Morgan R A, Ellul J P, Denton E R. et al . Malignant esophageal fistulas and perforations: management with plastic-covered metallic endoprostheses.  Radiology. 1997;  204 527-532
  PubMedGoogle Scholar
• 32 Siersema P D, Schrauwen S L, van Blankenstein M. et al . Self-expanding metal stents for complicated and recurrent esophagogastric cancer.  Gastrointest Endosc. 2001;  54 579-586
  CrossrefPubMedGoogle Scholar
• 33 Dumonceau J M, Cremer M, Lalmand B, Deviere J. Esophageal fistula sealing: choice of stent, practical management, and cost.  Gastrointest Endosc. 1999;  49 70-78
  CrossrefPubMedGoogle Scholar
• 34 Homs M Y, Steyerberg E W, Eijkenboom W MH, Siersema P D. Predictors of outcome of single dose brachytherapy for the palliation of dysphagia from esophageal cancer. In press 2005. 
  PubMedGoogle Scholar

P. D. Siersema, M. D.

Department of Gastroenterology and Hepatology · Erasmus MC · University Medical Center Rotterdam

P. O. Box 2040 · 3000 CA Rotterdam · The Netherlands

Fax: +31-10-463-4682 ·

Email: p.siersema@erasmusmc.nl