Radical radiotherapy for carcinoma of the oesophagus: an effective alternative to surgery.
Affiliation
Department of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK.Issue Date
1998-07
Metadata
Show full item recordAbstract
BACKGROUND AND PURPOSE: Despite advances in operative and postoperative care, long term survival rates following radical oesophagectomy are poor. Surgery remains the mainstay of radical treatment despite various series reporting similar results for treatment with radiotherapy, in particular in the upper third of the oesophagus. We have studied a cohort of patients treated with definitive radiotherapy to examine the influence on survival of changes in diagnostic scanning and radiotherapy computer planning as well as various patient and disease related prognostic factors. PATIENTS AND METHODS: From 1985 to 1994, 101 patients with clinically localised carcinoma of the oesophagus were treated at the Christie Hospital with definitive radiotherapy. This included 11 patients with oesophageal adenocarcinoma. Diagnostic and planning techniques changed over the period studied, with increasing use of both diagnostic and radiotherapy planning CT scanning. Radiotherapy doses ranged from 45 to 52.5 Gy in 15 or 16 fractions over 3 weeks. RESULTS: The 3- and 5-year survival figures were 27% and 21%, respectively, corrected for intercurrent deaths. Survival was better for adenocarcinoma than squamous cell carcinoma, though not statistically significantly. The only significant prognostic factor (P = 0.01) was the use of diagnostic CT scanning (42% versus 13% 5-year survival with or without diagnostic CT scanning, respectively) which was associated with an increase in field size. Radiotherapy was well tolerated with no acute mortality or significant morbidity. Late stenosis requiring oesophageal was seen in five of 20 patients surviving 3 years or more. CONCLUSIONS: Survival following well planned radiotherapy is an effective alternative to surgery for both squamous cell and adenocarcinoma. Advances in staging and three-dimensional planning and the use of multimodality treatment may further improve survival.Citation
Radical radiotherapy for carcinoma of the oesophagus: an effective alternative to surgery. 1998, 48 (1):15-21 Radiother OncolJournal
Radiotherapy and OncologyPubMed ID
9756167Type
ArticleLanguage
enISSN
0167-8140Collections
Related articles
- The role of endoscopic ultrasound (EUS) in planning radiotherapy target volumes for oesophageal cancer.
- Authors: Thomas E, Crellin A, Harris K, Swift S, Montefiore DS
- Issue date: 2004 Nov
- Primary chemo-radiotherapy and selective oesophagectomy for oesophageal cancer: goal of cure with organ preservation.
- Authors: Wilson KS, Lim JT
- Issue date: 2000 Feb
- Dose, volume, and tumor control prediction in primary radiotherapy of non-small-cell lung cancer.
- Authors: Willner J, Baier K, Caragiani E, Tschammler A, Flentje M
- Issue date: 2002 Feb 1
- Quantification and reduction of cardiac dose in radical radiotherapy for oesophageal cancer.
- Authors: Cominos M, Mosleh-Shirazi MA, Tait D, Henrys A, Cornes P
- Issue date: 2005 Dec
- 101 oesophageal cancers: a surgeon uses radiotherapy.
- Authors: Earlam RJ, Johnson L
- Issue date: 1990 Jan