BACKGROUND: A majority of patients with esophageal cancer present with inoperable disease and require rapid and long-lasting palliation of dysphagia. STUDY AIM: To compare the duration of relief of dysphagia in patients with inoperable esophageal cancer treated withesophageal stenting alone or a combination of esophageal stenting and external beam radiotherapy (EBRT), and to assess overall survival, treatment-related complications, and quality of life (QOL) in the two groups. PATIENTS AND METHODS: Patients with inoperable esophageal cancer and with high grade dysphagia were randomized to receive esophageal stenting with self-expandable metal stent (Ultraflex) alone (Group I), versus a combination of stenting followed by EBRT (30 gray in ten divided fractions over 2 weeks) (Group II). Dysphagia relief, overall survival, QOL (using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30, version 3), and treatment-related complications were assessed in the two groups. RESULTS:From April 2007 to March 2009, 84 patients were randomized to receive esophageal stent alone (42 patients) or a combination of stent and EBRT (42 patients). The two groups were comparable in demographics, tumor characteristics, indications for palliative treatment, and pretreatment dysphagia score. Dysphagia scores improved significantly in both groups following stent insertion. However, dysphagia relief was more sustained in Group II than in Group I (7 vs. 3 months, p = 0.002). Overall median survival was significantly higher in Group II than in Group I (180 vs. 120 days, p = 0.009). Addition of radiotherapy following stenting prolonged the mean dysphagia-free survival (118.6 ± 55.8 vs. 96.8 ± 43.0 days, p = 0.054). There was significant improvement in all QOL parameters at 1 week after stenting. The QOL, however, significantly declined immediately after radiotherapy. There was no treatment-related mortality, and the incidence of complications was similar in the two groups. CONCLUSION: Post-stenting EBRT effectively prolongs duration of dysphagia relief and improves overall survival in inoperable esophageal cancer.
RCT Entities:
BACKGROUND: A majority of patients with esophageal cancer present with inoperable disease and require rapid and long-lasting palliation of dysphagia. STUDY AIM: To compare the duration of relief of dysphagia in patients with inoperable esophageal cancer treated with esophageal stenting alone or a combination of esophageal stenting and external beam radiotherapy (EBRT), and to assess overall survival, treatment-related complications, and quality of life (QOL) in the two groups. PATIENTS AND METHODS: Patients with inoperable esophageal cancer and with high grade dysphagia were randomized to receive esophageal stenting with self-expandable metal stent (Ultraflex) alone (Group I), versus a combination of stenting followed by EBRT (30 gray in ten divided fractions over 2 weeks) (Group II). Dysphagia relief, overall survival, QOL (using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30, version 3), and treatment-related complications were assessed in the two groups. RESULTS: From April 2007 to March 2009, 84 patients were randomized to receive esophageal stent alone (42 patients) or a combination of stent and EBRT (42 patients). The two groups were comparable in demographics, tumor characteristics, indications for palliative treatment, and pretreatment dysphagia score. Dysphagia scores improved significantly in both groups following stent insertion. However, dysphagia relief was more sustained in Group II than in Group I (7 vs. 3 months, p = 0.002). Overall median survival was significantly higher in Group II than in Group I (180 vs. 120 days, p = 0.009). Addition of radiotherapy following stenting prolonged the mean dysphagia-free survival (118.6 ± 55.8 vs. 96.8 ± 43.0 days, p = 0.054). There was significant improvement in all QOL parameters at 1 week after stenting. The QOL, however, significantly declined immediately after radiotherapy. There was no treatment-related mortality, and the incidence of complications was similar in the two groups. CONCLUSION: Post-stenting EBRT effectively prolongs duration of dysphagia relief and improves overall survival in inoperable esophageal cancer.
Authors: E U Schmid; A S Alberts; F Greeff; A P Terblanche; L Schoeman; W Burger; R A Shiels; D Friediger; A Van der Hoven; G Falkson Journal: Radiother Oncol Date: 1993-07 Impact factor: 6.280
Authors: Massimo Conio; Alessandro Repici; Giorgio Battaglia; Giovanni De Pretis; Luigi Ghezzo; Max Bittinger; Helmut Messmann; Jean-François Demarquay; Sabrina Blanchi; Michele Togni; Rita Conigliaro; Rosangela Filiberti Journal: Am J Gastroenterol Date: 2007-12 Impact factor: 10.864
Authors: Peter S N van Rossum; Nadia Haj Mohammad; Frank P Vleggaar; Richard van Hillegersberg Journal: Nat Rev Gastroenterol Hepatol Date: 2017-12-13 Impact factor: 46.802
Authors: Douglas Adamson; Jane Blazeby; Catharine Porter; Christopher Hurt; Gareth Griffiths; Annmarie Nelson; Bernadette Sewell; Mari Jones; Martina Svobodova; Deborah Fitzsimmons; Lisette Nixon; Jim Fitzgibbon; Stephen Thomas; Anthony Millin; Tom Crosby; John Staffurth; Anthony Byrne Journal: Health Technol Assess Date: 2021-05 Impact factor: 4.014
Authors: Julia Welsch; Philipp Günther Kup; Carsten Nieder; Veria Khosrawipour; Helmut Bühler; Irenäus A Adamietz; Khashayar Fakhrian Journal: J Cancer Date: 2016-01-01 Impact factor: 4.207