Low-Dose Versus High-Dose Radiation Therapy for the Palliation of Dysphagia From Esophageal Cancer: A Multicenter Retrospective Cohort Study

Publication date: Available online 24 October 2019Source: Practical Radiation OncologyAuthor(s): Bram D. Vermeulen, Paul M. Jeene, Jasmijn Sijben, Robin Krol, Heidi Rütten, Johannes A. Bogers, Pètra M. Braam, Peter D. SiersemaAbstractPurposeClinical evidence regarding optimal radiation dose for palliation of dysphagia from esophageal cancer is generally lacking. In an effort to investigate optimal radiation dose, we assessed 2 different radiation schedules for palliation of dysphagia.Methods and MaterialsWe performed a multicenter, retrospective study comparing low-dose radiation therapy (LR: 5 x 4 Gy external beam radiation therapy [EBRT]) with high-dose radiation therapy (HR: 10 x 3 Gy EBRT and 12-Gy single-dose intraluminal brachytherapy) for palliation of dysphagia in patients with inoperable or metastasized esophageal cancer. Primary outcome was improvement of dysphagia at 6 weeks after start of radiation therapy. Additional outcomes were persistent and recurrent dysphagia during patients’ remaining life, severe adverse events, and survival.ResultsIn total, 292 patients (LR, n = 117; HR, n = 175) were included in this study. After matching, 144 patients (72 in each group) were compared. Improvement of dysphagia at 6 weeks was achieved in 50% of patients after LR and in 66% after HR (P = .071). Persistent or recurrent dysphagia occurred in 64% of patients after LR and in 42% after HR (P = .012). No difference in the rate of severe adverse events was...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research

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Authors: Burchardt W, Chyrek A, Burchardt E, Bielęda G, Trojanowski M, Chicheł A Abstract Purpose: The goal of this study was to assess the effectiveness of dysphagia relief and overall survival in patients with advanced esophageal cancer treated with palliative high-dose-rate (HDR) brachytherapy (BT) without computed tomography-based planning. Material and methods: Palliative 2D HDR-BT was used to treat 93 patients with advanced or incurable esophageal cancer in a regional cancer center from October 2010 to December 2016. Before the treatment patients presented the following grades of dysphagia: 0 - 0%, I - ...
Source: Journal of Contemporary Brachytherapy - Category: Cancer & Oncology Tags: J Contemp Brachytherapy Source Type: research
Authors: Kind S, Merenkow C, Büscheck F, Möller K, Dum D, Chirico V, Luebke AM, Höflmayer D, Hinsch A, Jacobsen F, Göbel C, Weidemann S, Fraune C, Möller-Koop C, Hube-Magg C, Clauditz TS, Simon R, Sauter G, Wilczak W, Bawahab AA, Izbicki JR, Perez D, Marx A Abstract Syndecan-1 (CD138) is a transmembrane proteoglycan known to be expressed in various normal and malignant tissues. It is of interest because of a possible prognostic role of differential expression in tumors and its role as a target for indatuximab, a monoclonal antibody coupled with a cytotoxic agent. To comprehensively analyze ...
Source: Disease Markers - Category: Laboratory Medicine Tags: Dis Markers Source Type: research
Publication date: April 2020Source: Biomedicine &Pharmacotherapy, Volume 124Author(s): Yong Zhou, Bo Tian, Jinming Tang, Jie Wu, Hui Wang, Zhining Wu, Xu Li, Desong Yang, Baihua Zhang, Yuhang Xiao, Ying Wang, Junliang Ma, Wenxiang Wang, Min SuAbstractLong noncoding RNAs (lncRNAs) are a group of RNAs that lack protein-coding ability, with lengths greater than 200 nucleotides. Increasing evidence has indicated that they mediate multiple physiological and pathological processes by regulating gene expression at the epigenetic, transcriptional, post-transcriptional, and translational levels. The deregulation of lncRNAs was ...
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
Escalating the radiation dose does not improve outcomes in patients receiving definitive chemoradiation.Medscape Medical News
Source: Medscape Hematology-Oncology Headlines - Category: Cancer & Oncology Tags: Hematology-Oncology News Source Type: news
We examined the prognostic differences in 527 patients with MPC according to the diagnosis time. In 325 patients of long-term survivors in whom MPC was diagnosed ≥ 5 years postoperative, 5-year survival rate and the median survival time after diagnosis were 35.1% and 17.7 months, respectively. This outcome was significantly poorer than that of 160 patients in whom MPC was diagnosed within 5 years postoperative (58.5% and 62.7 months, P
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research
Publication date: Available online 23 January 2020Source: Clinics and Research in Hepatology and GastroenterologyAuthor(s): Bin Wei, Lijuan Xu, Hongxia Hui, Yuan Sun, Jingjing WuSummaryIntroductionCombination therapy with cisplatin is the conventional first-line treatment in patients with locally advanced or metastatic esophageal squamous cell carcinoma (ESCC). Ubiquitin-specific protease 9X (USP9X) has been shown to be associated with resistance to chemotherapy drugs in several cancers. The purpose of this study was to explore the predictive effects of USP9X on advanced ESCC patients treated with cisplatin-based regi...
Source: Clinics and Research in Hepatology and Gastroenterology - Category: Gastroenterology Source Type: research
Authors: Lai G, Guo N, Jiang Y, Lai J, Li Y, Lai R Abstract OBJECTIVE: To assess whether the duration of one-lung ventilation (OLV) affects postoperative pulmonary complications after McKeown esophagectomy for esophageal cancer. METHODS: A retrospective analysis of data stored in a database for esophageal cancer was carried out to identify predictors of postoperative pulmonary complications in patients undergoing McKeown esophagectomy at Sun Yat-sen University Cancer Center between 2010 and 2012. RESULTS: Patients in the OLV ⩾150 minutes group had a higher incidence of postoperative pulmonary complication...
Source: Tumori - Category: Cancer & Oncology Tags: Tumori Source Type: research
Authors: Lan T, Xiao Z, Luo H, Su K, Yang O, Zhan C, Lu Y Abstract Esophageal cancer (ESCA) carries a poor prognosis among gastrointestinal malignancies. The present study developed a signature based on mRNAs and long non-coding RNAs (lncRNAs) to predict prognosis in ESCA by using The Cancer Genome Atlas database. By using least absolute shrinkage and selection operator penalized regression, a set of RNAs (three mRNAs and two lncRNAs) was identified and used to build a risk score system of ESCA prognosis, which was used to stratify patients having considerable diverse survival in the training set [hazard ratio (HR)...
Source: Oncology Letters - Category: Cancer & Oncology Tags: Oncol Lett Source Type: research
AbstractPurposeThe dose received by the lungs in radiotherapy (RT) is affected by the patient ’s current lung volume. The presence of predictive factors and cut-off points were investigated to achieve acceptable lung doses in esophageal cancer (EC) treatment.MethodsVirtual RT volumes of supracarinal EC were delineated. RT plans were designed with standard criteria in the TomoTherapy planning system (TomoTherapy Inc., Madison, WI, USA). The total dose was 50.4  Gy (1.8 Gy/fraction). ROC (Receiver operating characteristic) analysis and Mann–Whitney U tests were performed.ResultsThere was a  total of...
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
ConclusionPerforming prophylactic ligation of the thoracic duct branch during right pulmonary resection and mediastinal lymph-node dissection is an effective and safe method of preventing postoperative chylothorax.
Source: Surgery Today - Category: Surgery Source Type: research
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