title: Underuse of brachytherapy for the treatment of dysphagia owing to esophageal cancer. An Italian survey.
abstract: BACKGROUND
  International guidelines strongly recommend brachytherapy as valid alternative or in addition to stenting in patients with dysphagia owing to esophageal cancer. However, for not well understood reasons, brachytherapy is definitively underused for the palliative treatment of malignant dysphagia. Aim of the current survey was to investigate the use of brachytherapy for the treatment of malignant dysphagia in Italy.
  
  
  METHODS
  A structured questionnaire was submitted to the 1510 members of the Italian Association of Radiation Oncologists (AIRO). These members refer to 177 centres of radiotherapy across Italy and in 68 (38.4%) of them brachytherapy is routinely performed.
  
  
  RESULTS
  Of the 1510 invited members, 178 completed the survey (11.7%). The answers provided by the 178 participants allowed to get information on 40 out of 68 brachytherapy centres (58.8%). Seven out of 40 (17.5%) centres perform brachytherapy of the oesophagus, in 3 out of 40 (7.5%) centres brachytherapy represents the first line of treatment. The main reason why brachytherapy is not routinely performed is the lack of experience.
  
  
  CONCLUSIONS
  Despite the strong recommendations of the international guidelines and the wide diffusion of brachytherapy centres across Italy, only very few of them routinely considered brachytherapy for the treatment of dysphagia due to esophageal cancer.
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. Electronic address: lorenzofuccio@gmail.com.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fuccio
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Guido
authors.affiliation: Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Hassan
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Frazzoni
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Arcelli
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Farioli
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Giaccherini
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Galuppi
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Mandolesi
authors.affiliation: Department of Radiotherapy, Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cellini
authors.affiliation: Radiation Oncology Unit, State Hospital, Ancona, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mantello
authors.affiliation: Department of Radiotherapy, Fondazione di Ricerca e Cura "Giovanni Paolo II", Campobasso, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Macchia
authors.affiliation: Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: de Bortoli
authors.affiliation: Digestive Endoscopy Unit, Humanitas Research Hospital, Rozzano (MI), Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Repici
authors.affiliation: Department of Radiotherapy, Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Valentini
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Bazzoli
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Alessio Giuseppe
authors.initials: AG
authors.lastname: Morganti
mesh_terms: D001918:Brachytherapy / Q000706:statistics & numerical data*; D003680:Deglutition Disorders / Q000532:radiotherapy*; D004938:Esophageal Neoplasms / Q000150:complications*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D008495:Medical Oncology; D010166:Palliative Care / Q000379:methods*; D010820:Physicians; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D011795:Surveys and Questionnaires
keywords: Brachytherapy; Dysphagia; Esophageal cancer; Palliation