Damodara Kumaran1, Subhashini John2, Rajesh Isiah2, Saikat Das2. 1. Christian Medical College and Hospital, Vellore, Tamil Nadu, India. damodar.dr@gmail.com. 2. Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
Abstract
PURPOSE: Oesophageal malignancy is the fourth commonest cancer which has a very poor outcome. In the management of oesophageal malignancy, radiation therapy is underutilized by many physicians due to feared complications though its role is well proven in literature. This study brings the role of radiation therapy in terms of loco-regional and distant relapse. This study characterizes demographic characteristics, treatment modality and the impact of these on recurrence-free survival of locally advanced carcinoma oesophagus. METHOD: In a retrospective analysis over a period of 24 months, 28 patients diagnosed to have locally advanced oesophageal malignancy were included. Neoadjuvant chemotherapy was carried out in 4 patients and concurrent chemoradiotherapy in 18 patients. Among the 28 patients, 7 patients who were operable and fit underwent surgery 6-8 weeks after completion of the planned neoadjuvant therapy. All patients received concurrent chemoradiation for a period of 5 weeks with platinum and/or taxane-based chemotherapy. RESULTS: With a median follow-up of 12 months, loco-regional recurrence and distant relapse were substantially less with 14 and 10 %, respectively. The Kaplan-Meier recurrence-free survival was 60 % at 24 months. All patients who had surgery as a part of the multimodality management were disease free at the last follow-up. CONCLUSION: In locally advanced oesophageal malignancy, radiation therapy plays an important role in downsizing the tumour for operability or can also be utilized as the sole modality of management.
PURPOSE:Oesophageal malignancy is the fourth commonest cancer which has a very poor outcome. In the management of oesophageal malignancy, radiation therapy is underutilized by many physicians due to feared complications though its role is well proven in literature. This study brings the role of radiation therapy in terms of loco-regional and distant relapse. This study characterizes demographic characteristics, treatment modality and the impact of these on recurrence-free survival of locally advanced carcinoma oesophagus. METHOD: In a retrospective analysis over a period of 24 months, 28 patients diagnosed to have locally advanced oesophageal malignancy were included. Neoadjuvant chemotherapy was carried out in 4 patients and concurrent chemoradiotherapy in 18 patients. Among the 28 patients, 7 patients who were operable and fit underwent surgery 6-8 weeks after completion of the planned neoadjuvant therapy. All patients received concurrent chemoradiation for a period of 5 weeks with platinum and/or taxane-based chemotherapy. RESULTS: With a median follow-up of 12 months, loco-regional recurrence and distant relapse were substantially less with 14 and 10 %, respectively. The Kaplan-Meier recurrence-free survival was 60 % at 24 months. All patients who had surgery as a part of the multimodality management were disease free at the last follow-up. CONCLUSION: In locally advanced oesophageal malignancy, radiation therapy plays an important role in downsizing the tumour for operability or can also be utilized as the sole modality of management.
Authors: J F Bosset; M Gignoux; J P Triboulet; E Tiret; G Mantion; D Elias; P Lozach; J C Ollier; J J Pavy; M Mercier; T Sahmoud Journal: N Engl J Med Date: 1997-07-17 Impact factor: 91.245
Authors: J S Cooper; M D Guo; A Herskovic; J S Macdonald; J A Martenson; M Al-Sarraf; R Byhardt; A H Russell; J J Beitler; S Spencer; S O Asbell; M V Graham; L L Leichman Journal: JAMA Date: 1999-05-05 Impact factor: 56.272
Authors: B D Minsky; D Neuberg; D P Kelsen; T M Pisansky; R J Ginsberg; T Pajak; M Salter; A B Benson Journal: Int J Radiat Oncol Biol Phys Date: 1999-02-01 Impact factor: 7.038
Authors: E Le Prise; P L Etienne; B Meunier; G Maddern; M Ben Hassel; D Gedouin; D Boutin; J P Campion; B Launois Journal: Cancer Date: 1994-04-01 Impact factor: 6.860
Authors: Yichun Wang; Li Zhang; Dongmei Ye; Wanli Xia; Jun Jiang; Xiumei Wang; Mingxia Zhang; Fan Wang Journal: Oncol Lett Date: 2018-01-16 Impact factor: 2.967