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

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.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Tags: Review Article Source Type: research

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This study aims to assess the improvement in dysphagia, associated complications and overall and disease-free survival with intraluminal brachytherapy (ILRT) as palliative care in advanced esophageal cancer.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research
Publication date: Available online 22 November 2018Source: Best Practice &Research Clinical GastroenterologyAuthor(s): R.D. van der Bogt, B.D. Vermeulen, A.N. Reijm, P.D. Siersema, M.C.W. SpaanderAbstractPalliation of dysphagia is the cornerstone of palliative treatment in patients with incurable oesophageal cancer. Available palliative options for dysphagia are oesophageal stent placement and radiotherapy. In general, oesophageal stent placement is the preferred therapeutic option in patients with a relatively poor prognosis because of its rapid relief of dysphagia. Regardless of ongoing technical developments, recurr...
Source: Best Practice and Research Clinical Gastroenterology - Category: Gastroenterology Source Type: research
Conclusion: Spectrum of tracheal stenoses and bronchoscopic therapeutic procedures used during last 20 years in not changing essentially, but in P2 period patients were older, with more comorbidities and shorter survival.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
;ro L Abstract Endobronchial brachytherapy could be proposed in case of endoluminal tumours either as a palliative or a curative treatment. As a curative treatment, endobronchial brachytherapy could obtain a high local control rate in case of limited disease. In palliative setting, endobronchial brachytherapy improved thoracic symptoms in more than 80% of cases, but it is less efficient than external beam radiation therapy for palliation. It could be also proposed to maintain the airway open after laser therapy. Oesophageal brachytherapy is a valuable option as a palliative treatment, underused at this time. It ca...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research
DiscussionWhile there appears to be no immediate short-term differences, those who live longer than 3  months experience a significant improvement in dysphagia score using a stents combination therapy approach vs stents alone. The combination therapy significantly improves the overall survival as well as showed improvements in quality of life scores. Larger randomized controlled trials are needed t o assess improvements in dysphagia score, overall survival, quality of life, and adverse events.
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
Self-expanding metal stents (SEMS) appear to be the most effective treatment for dysphagia in palliative patients suffering from malignant esophageal cancers (EC), providing immediate relief to dysphagia in a single treatment step. Recent recommendations from the European Society of Gastrointestinal Endoscopy further recommend the use of brachytherapy in addition to stenting in patients with longer life expectancies due to possible improved survival advantage and quality of life [Spaanderet  al. Endoscopy 48, 939-948 (2016)].
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research
CONCLUSIONS: 1. Endoscopic implantation of stents to the lumen of the esophagus provides access to esophagus and, in many cases, allows application of HDR-BT. 2. HDR-BT for advanced esophageal cancer brought relief from dysphagia in most of patients. 3. The combination of the two methods of treatment represents an effective choice for palliative care of this group of patients, with a complication rate similar to observed one in the instance of brachytherapy alone. PMID: 27799950 [PubMed - in process]
Source: Journal of Contemporary Brachytherapy - Category: Cancer & Oncology Tags: J Contemp Brachytherapy Source Type: research
Endoscopy DOI: 10.1055/s-0042-114210This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations for malignant disease 1 ESGE recommends placement of partially or fully covered self-expandable m...
Source: Endoscopy - Category: Gastroenterology Authors: Tags: Guideline Source Type: research
Recurrent esophago-gastric junction adenocarcinoma is not a rare event and its correct management is still debated. Many approaches for the treatment of these patients exist, but only few studies compare the different techniques. Most of the studies are retrospectives series and describe the experiences of single institutions in the treatment of recurrent esophageal and esophago-gastric junction cancers. Nowadays surgery is still the main and only curative treatment. Other alternative palliative therapies could be endoscopic stent placement and balloon dilation, photodynamic therapy, thermal tumor ablation (laser photoabla...
Source: Surgical Oncology - Category: Surgery Authors: Source Type: research
International guidelines strongly recommend brachytherapy as valid alternative or in addition to stenting in patients with dysphagia owing to esophageal cancer. However, for not well understood reasons, brachytherapy is definitively underused for the palliative treatment of malignant dysphagia. Aim of the current survey was to investigate the use of brachytherapy for the treatment of malignant dysphagia in Italy.
Source: Digestive and Liver Disease - Category: Gastroenterology Authors: Tags: Oncology Source Type: research
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