Brachytherapy appears safe, effective in esophageal cancer
1/27/2004 San Francisco Edward Susman Gastrointestinal Cancer Symposium Esophageal cancer patients who are deemed poor surgical candidates may benefit from endoscopically guided brachytherapy, as administered by a team of radiation oncologists and gastroenterologists, according to a Canadian study. The multidisciplinary approach to treatment resulted in no esophageal perforations in a series of 60 patients, reported Dr. Te Vuong and colleagues at the first Gastrointestinal Cancers Symposium last week in San Francisco. The meeting was sponsored by the American Society for Therapeutic Radiology and Oncology (ASTRO), the Society of Surgical Oncology (SSO), the American Gastroenterological Association (AGA), and the American Society of Clinical Oncology (ASCO). According to the poster presentation from the McGill University Health Centre in Montreal, the elderly patients with adenocarcinoma or squamous cell carcinoma of the esophagus were treated with high-dose-rate brachytherapy prior to external-beam radiation therapy. The patients received 20-Gy doses in five fractions, prescribed at 1 cm from the source to the initial tumor bed. The tumor was identified by direct endoscopy. Radio-oblique clips were placed above and below the tumor at the time of endoscopy for quality control of tumor bed localization. Chemotherapy and/or reduced radiation doses were dependent upon the individual patients' performance status. "After a median follow-up of 18 months for all 60 patients treated between 1996 and 2003, we saw about a 25% local recurrence rate of the cancer," Vuong said. "Historically we might expect to see a 50% recurrence in these patients, so we believe that we have provided a benefit [...]