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dc.contributor.authorSykes, Andrew J
dc.contributor.authorBurt, Paul A
dc.contributor.authorSlevin, Nicholas J
dc.contributor.authorStout, Ronald
dc.contributor.authorMarrs, Julie E
dc.date.accessioned2010-01-23T12:39:11Z
dc.date.available2010-01-23T12:39:11Z
dc.date.issued1998-07
dc.identifier.citationRadical radiotherapy for carcinoma of the oesophagus: an effective alternative to surgery. 1998, 48 (1):15-21 Radiother Oncolen
dc.identifier.issn0167-8140
dc.identifier.pmid9756167
dc.identifier.urihttp://hdl.handle.net/10541/90496
dc.description.abstractBACKGROUND 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.
dc.language.isoenen
dc.subjectOesophageal Canceren
dc.subject.meshAdenocarcinoma
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshCarcinoma, Squamous Cell
dc.subject.meshCohort Studies
dc.subject.meshEsophageal Neoplasms
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPrognosis
dc.subject.meshRadiotherapy Dosage
dc.subject.meshRadiotherapy Planning, Computer-Assisted
dc.subject.meshRadiotherapy, High-Energy
dc.subject.meshRetrospective Studies
dc.subject.meshSurvival Analysis
dc.subject.meshTomography, X-Ray Computed
dc.titleRadical radiotherapy for carcinoma of the oesophagus: an effective alternative to surgery.en
dc.typeArticleen
dc.contributor.departmentDepartment of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK.en
dc.identifier.journalRadiotherapy and Oncologyen
html.description.abstractBACKGROUND 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.


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