Abstract:
BACKGROUND AND PURPOSE:Esophageal neoplasm has a poor prognosis, and palliative care remains an important goal of treatment. The purpose of this study was to assess the ability of high-dose-rate brachytherapy (HDRB) to improve dysphagia in 115 patients treated at our institution. METHODS AND MATERIALS:Patients previously submitted to external beam radiotherapy that at least, 1 month after, presented with residual disease and persistent dysphagia, were given HDRB as palliative treatment. Patients with tumors extending to the level of cardia and those with cervical esophageal lesions were also eligible. HDRB consisted of three fractions of 500 cGy given weekly. Dysphagia was assessed using a food texture-based scale classified according to the type of food patients were able to swallow (absent, solid, pasty, or liquid). At the end of treatment, a single-category shift in dysphagia classification was scored as +1 (e.g., liquid to pasty) or -1 (e.g., solid to pasty), and a dual-category shift was scored as +2 (e.g., liquid to solid) or -2 (e.g., absent to pasty). RESULTS:Most patients (51.1%) had improvement of dysphagia, and 55.3% of this group experienced one-point improvement. Procedural complications included stricture (38.2%), bleeding (7%), and fistula (8.7%). In the present study, 13 patients with cervical esophageal lesions underwent HDRB without fistula formation. CONCLUSIONS:Esophageal HDRB effectively reduces dysphagia. Tumor location was not related to development of complications.
journal_name
Brachytherapyjournal_title
Brachytherapyauthors
Grazziotin Reisner R,Reisner ML,Ferreira MA,Rosa AA,Veras IM,Carneiro TM,Wolff B,Viégas CM,Mendonça de Araújo CM,Marchiori Edoi
10.1016/j.brachy.2014.09.007subject
Has Abstractpub_date
2015-01-01 00:00:00pages
84-90issue
1eissn
1538-4721issn
1873-1449pii
S1538-4721(14)00649-7journal_volume
14pub_type
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