title: Intraluminal brachytherapy in the management of squamous carcinoma of the esophagus.
abstract: Intraluminal high dose rate brachytherapy (ILHDR BT) is one of several effective modalities for palliation of advanced esophageal cancer. Thirty patients with endoscopic-proven, mostly locally advanced, squamous cell carcinoma of the esophagus, not involving the gastroesophageal junction and without distant metastases, were included in this analysis. Twenty-nine patients received two ILHDR BT sessions of 8 Gy within a week and one patient received only one session. All patients were followed monthly. Outcomes included quality of life (QOL), symptoms control: dysphagia, regurgitation, odynophagia, and chest or back pain, as well as, overall survival. Through 4 months of follow-up, QOL was statistically improved (having lowered scores) in regards to feelings (P= 0.013), sleeping (P= 0.032), eating (P= 0.020), and social life (P= 0.002). The most significantly improved symptom was dysphagia (P < 0.006), with a reduction of 0.52 units or one-half grade. Regurgitation, odynophagia, and pain were lower during follow-up but were not statistically significant. The median overall survival from death of any cause was 165 days (with a 95% confidence interval of 128-195 days). In conclusion, ILHDR BT of advanced squamous esophageal cancer consisting of two out-patient procedures is very successful in achieving the primary objectives of the patients to reduce dysphagia and improve QOL.
authors.affiliation: Oncology and Nuclear Medicine, Sestre milosrdnice, University Hospital, 10 000 Zagreb, Croatia. afrobe@irb.h
authors.forename: Ana
authors.initials: A
authors.lastname: Frobe
authors.forename: Glenn
authors.initials: G
authors.lastname: Jones
authors.forename: Blanka
authors.initials: B
authors.lastname: Jaksić
authors.forename: Tomislav
authors.initials: T
authors.lastname: Bokulić
authors.forename: Mirjana
authors.initials: M
authors.lastname: Budanec
authors.forename: Mrcela
authors.initials: M
authors.lastname: Iva
authors.forename: Dinko
authors.initials: D
authors.lastname: Stancić-Rokotov
authors.forename: Davor
authors.initials: D
authors.lastname: Hrabar
authors.forename: Ante
authors.initials: A
authors.lastname: Bolanca
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rosenblatt
authors.forename: Zvonko
authors.initials: Z
authors.lastname: Kusić
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D002423:Cause of Death; D004938:Esophageal Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011446:Prospective Studies; D011788:Quality of Life; D011879:Radiotherapy Dosage