Terufumi Kawamoto1, Naoki Nakamura2, Tetsuo Saito3, Ayako Tonari4, Hitoshi Wada5, Hideyuki Harada6, Hikaru Kubota7, Hisayasu Nagakura8, Joichi Heianna9, Kazunari Miyazawa10, Kazunari Yamada11, Masao Tago12, Masato Fushiki13, Miwako Nozaki14, Nobue Uchida15, Norio Araki16, Shuhei Sekii17, Takashi Kosugi18, Takeo Takahashi19, Naoto Shikama1. 1. Department of Radiation Oncology, Juntendo University Hospital, Tokyo, Japan. 2. Department of Radiation Oncology, St. Marianna University School of Medicine Hospital, Kawasaki, Japan. 3. Department of Radiation Oncology, Arao Municipal Hospital, Kumamoto, Japan. 4. Department of Radiation Oncology, Kyorin University Hospital, Mitaka, Japan. 5. Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center, Fukushima, Japan. 6. Division of Radiation Therapy, Radiation and Proton Therapy Center, Shizuoka Cancer Center Hospital, Shizuoka, Japan. 7. Department of Radiation Oncology, Kobe University Hospital, Kobe, Japan. 8. Department of Radiology, KKR Sapporo Medical Center, Sapporo, Japan. 9. Department of Radiation Oncology, Ryukyu University Hospital, Nishihara, Japan. 10. Department of Radiology, Showa General Hospital, Kodaira, Japan. 11. Department of Radiation Oncology, Seirei Mikatahara General Hospital, Hamamatsu, Japan. 12. Department of Radiology, Teikyo University Hospital, Tokyo, Japan. 13. Department of Radiation Oncology, Nagahama City Hospital, Nagahama, Japan. 14. Department of Radiation Oncology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan. 15. Department of Radiation Oncology, Tokyo Saiseikai Central Hospital, Tokyo, Japan. 16. Department of Radiation Oncology, Kyoto Medical Center, Kyoto, Japan. 17. Department of Radiation Oncology, Kita-Harima Medical Center, Ono, Japan. 18. Department of Radiation Oncology, Fujieda Municipal General Hospital, Fujieda, Japan. 19. Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Abstract
BACKGROUND: International guidelines recommend brachytherapy for patients with dysphagia from esophageal cancer, whereas brachytherapy is infrequently used to palliate dysphagia in some countries. To clarify the availability of palliative treatment for dysphagia from esophageal cancer and explain why brachytherapy is not routinely performed are unknown, this study investigated the use of brachytherapy and external beam radiotherapy for dysphagia from esophageal cancer. METHODS: Japanese Radiation Oncology Study Group members completed a survey and selected the treatment that they would recommend for hypothetical cases of dysphagia from esophageal cancer. RESULTS: Of the 136 invited facilities, 61 completed the survey (44.9%). Four (6.6%) facilities performed brachytherapy of the esophagus, whereas brachytherapy represented the first-line treatment at three (4.9%) facilities. Conversely, external beam radiotherapy alone and chemoradiotherapy were first-line treatments at 61 and 58 (95.1%) facilities, respectively. In facilities that performed brachytherapy, the main reason why brachytherapy of the esophagus was not performed was high invasiveness (30.2%). Definitive-dose chemoradiotherapy with (≥50 Gy) tended to be used in patients with expected long-term survival. CONCLUSIONS: Few facilities routinely considered brachytherapy for the treatment of dysphagia from esophageal cancer in Japan. Conversely, most facilities routinely considered external beam radiotherapy. In the future, it will be necessary to optimize external beam radiotherapy.
BACKGROUND: International guidelines recommend brachytherapy for patients with dysphagia from esophageal cancer, whereas brachytherapy is infrequently used to palliate dysphagia in some countries. To clarify the availability of palliative treatment for dysphagia from esophageal cancer and explain why brachytherapy is not routinely performed are unknown, this study investigated the use of brachytherapy and external beam radiotherapy for dysphagia from esophageal cancer. METHODS: Japanese Radiation Oncology Study Group members completed a survey and selected the treatment that they would recommend for hypothetical cases of dysphagia from esophageal cancer. RESULTS: Of the 136 invited facilities, 61 completed the survey (44.9%). Four (6.6%) facilities performed brachytherapy of the esophagus, whereas brachytherapy represented the first-line treatment at three (4.9%) facilities. Conversely, external beam radiotherapy alone and chemoradiotherapy were first-line treatments at 61 and 58 (95.1%) facilities, respectively. In facilities that performed brachytherapy, the main reason why brachytherapy of the esophagus was not performed was high invasiveness (30.2%). Definitive-dose chemoradiotherapy with (≥50 Gy) tended to be used in patients with expected long-term survival. CONCLUSIONS: Few facilities routinely considered brachytherapy for the treatment of dysphagia from esophageal cancer in Japan. Conversely, most facilities routinely considered external beam radiotherapy. In the future, it will be necessary to optimize external beam radiotherapy.
Authors: Albert Biete; György Kovács; Ángeles Rovirosa; Luca Tagliaferri; Adam Chicheł; Valentina Lancellotta; Yaowen Zhang; Gabriela Antelo; Peter Hoskin; Elzbieta Van Der Steen-Banasik Journal: J Contemp Brachytherapy Date: 2022-06-30