Endoluminal high-dose-rate brachytherapy for locally recurrent or persistent esophageal cancer Journal Article

Authors: Taggar, A. S.; Pitter, K. L.; Cohen, G. N.; Schattner, M.; Gerdes, H.; Markowitz, A. J.; Ilson, D.; Brady, P.; Cuaron, J. J.; Goodman, K. A.; Wu, A. J.
Article Title: Endoluminal high-dose-rate brachytherapy for locally recurrent or persistent esophageal cancer
Abstract: Purpose: Management of locally recurrent or persistent esophageal cancer (EC) after standard chemoradiation is challenging. This study updates our experience of treating medically inoperable EC patients with endoluminal high-dose-rate brachytherapy (EHDRBT) including the patients treated with a novel multiballoon channel centering esophageal applicator. Methods and Materials: Thirty-three consecutive patients with early-stage primary (n = 7), posttreatment persistent (n = 7), and recurrent (n = 19) EC treated with EHDRBT at our institution were included. Median dose and treatment lengths were 14 Gy (range 10–17.5 Gy) and 6 cm (3.5–9.0 cm), respectively. Endoscopy and biopsy were performed 3 months after EHDRBT and then every 3–6 months thereafter. Results: Median followup was 17.4 months (range 5.0–88.3). Grade 1 and 2 toxicities were observed in 13 (44.8%) and 11 (37.9%) patients, respectively. Grade 3 toxicity (tracheoesophageal fistula) was observed in 1 patient who had previously received two courses of external beam radiotherapy as well as a stent insertion. Median overall survival (OS) for entire cohort was 20.9 months, and 1-year OS was 78%. Complete response was achieved in 58.6% of patients with median time to failure and 1-year disease-free survival of 10.3 months (range 5.4–28.2) and 27%, respectively. Conclusions: For medically inoperable patients with early-stage primary or local posttreatment residual or recurrent EC, EHDRBT is a well-tolerated treatment option with minimal Grade ≥3 toxicity. Brachytherapy in our hands continues to be a safe treatment option. Although 58.6% of patients achieved a complete response and the OS of this cohort is relatively good, long-term local control and cure remains a challenge. © 2018 American Brachytherapy Society
Keywords: brachytherapy; esophageal cancer; recurrent; early stage; high-dose-rate
Journal Title: Brachytherapy
Volume: 17
Issue: 3
ISSN: 1538-4721
Publisher: Elsevier Science, Inc.  
Date Published: 2018-05-01
Start Page: 621
End Page: 627
Language: English
DOI: 10.1016/j.brachy.2018.01.010
PROVIDER: scopus
PUBMED: 29496425
Notes: Article -- Export Date: 1 June 2018 -- Source: Scopus
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MSK Authors
  1. Hans Gerdes
    125 Gerdes
  2. Arnold J Markowitz
    109 Markowitz
  3. Gilad N Cohen
    132 Cohen
  4. Abraham Jing-Ching Wu
    199 Wu
  5. David H Ilson
    269 Ilson
  6. Mark Schattner
    102 Schattner
  7. Ken L Pitter
    41 Pitter
  8. John Jacob Cuaron
    40 Cuaron
  9. Paul James Brady
    8 Brady
  10. Amandeep Singh Taggar
    15 Taggar