The role of palliative interventional radiotherapy (brachytherapy) in esophageal cancer: An AIRO (Italian Association of Radiotherapy and Clinical Oncology) systematic review focused on dysphagia-free survival

V. Lancellotta, F. Cellini, B. Fionda, V. De Sanctis, C. Vidali, V. Fusco, F. Barbera, M.A. Gambacorta, R. Corvò, S.M. Magrini, L. Tagliaferri

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The aim of this review was to examine efficacy of palliative interventional radiotherapy (IRT) in esophageal cancer compared with other treatment in terms of dysphagia-free survival (DyFS) and safety. Methods and Material: A systematic research using PubMed, Scopus, and Cochrane library was performed to identify full articles evaluating the efficacy of IRT as palliation in patients with esophageal cancer. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. We analyzed only clinical study as full text of patients with symptomatic esophageal cancer treated with IRT alone or in combination with other treatment. Conference paper, survey, letter, editorial, book chapter, and review were excluded. Time restriction (1990–2018) as concerns the years of the publication was considered. The primary outcome was the duration of dysphagia relief (DyFS) after brachytherapy vs. other treatment (external-beam radiotherapy, photodynamic therapy, argon plasma coagulation, stent, and laser) during followup. Secondary outcomes included overall survival and adverse event rates. Results: The literature search resulted in 554 articles. Sixty-six articles were assessed via full text for eligibility. Of these, 59 articles were excluded for various reasons, leaving seven randomized studies. The number of evaluated patients was 905 patients, and median age was 70.5 years. In the IRT group, the median DyFS was 99 days, the most relevant G3–G4 toxicity were fistula development and stenosis reported, respectively, in 8.3% and 12.2%; the overall median survival was 175.5 days. Conclusion: In conclusion, we provided evidence-based support that IRT is an effective and safe treatment option; therefore, its underuse is no longer justified. © 2020 American Brachytherapy Society
Original languageEnglish
Pages (from-to)104-110
Number of pages7
JournalBrachytherapy
Volume19
Issue number1
DOIs
Publication statusPublished - 2020

Keywords

  • Brachytherapy
  • Esophageal cancer
  • Interventional radiotherapy
  • Palliative
  • argon plasma coagulation
  • brachytherapy
  • cancer palliative therapy
  • cancer radiotherapy
  • cancer survival
  • dysphagia
  • esophagus cancer
  • esophagus fistula
  • esophagus stenosis
  • external beam radiotherapy
  • follow up
  • human
  • intraoperative radiotherapy
  • outcome assessment
  • patient safety
  • photodynamic therapy
  • priority journal
  • Review
  • systematic review
  • adverse device effect
  • adverse event
  • complication
  • esophagus tumor
  • palliative therapy
  • procedures
  • radiation injury
  • randomized controlled trial (topic)
  • stent
  • survival rate
  • Deglutition Disorders
  • Esophageal Fistula
  • Esophageal Neoplasms
  • Esophageal Stenosis
  • Humans
  • Palliative Care
  • Radiation Injuries
  • Randomized Controlled Trials as Topic
  • Stents
  • Survival Rate

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