Official Annual Meeting of Indian Brachytherapy Society: 9th ANNUAL CONFERENCE OF INDIAN BRACHYTHERAPY SOCIETY 2019 (IBSCON 2019) PROCEEDINGS.

Abstract

PurposeTo evaluate and compare response and toxicities in patients treated with chemoradiation alone and chemoradiation with high dose rate intraluminal brachytherapy in carcinoma of the esophagus.Material and methodsA total of 60 patients were included in the study and were divided randomly into 1 arms – CT RT arm and ILBT arm with 30 patients each. CT RT received definitive chemoradiation 54 Gy in 27 fractions with concurrent weekly cisplatin and ILBT received definitive chemoradiation 50 Gy in 25 fractions with concurrent weekly cisplatin followed by two sessions of intraluminal brachytherapy of 4 Gy each. Evaluation of early response was done 1 and 6 months after completion of chemoradiation on a clinical basis and by upper GI endoscopy. Dysphagia scores were recorded before, on completion of treatment and in the 1st and 6th month of follow-up. Acute gastro-intestinal toxicities (fistula, stricture, ulcer, esophagitis) were evaluated.ResultsThe patient characteristics were comparable in both the arms. Dysphagia to solids was more frequent in the chemoradiation alone arm compared to the ILBT arm at the end of 1 month and 6 months. 80% had a complete clinical response in the CT-RT arm compared to 86.7.3% in the ILBT arm. Grade 3 stricture was more frequent in arm 2. Grade 2 ulceration was seen only in arm 2. None of the patients developed fistula or pneumonitis. There was improvement in dysphagia in both the arms with 50% in arm 1 and 67% in arm 2 tolerating a normal solid diet at the end of 6 months.ConclusionsChemoradiation with ILBT for carcinoma of the esophagus provides excellent local control of the disease with acceptable toxicities when compared with chemoradiation alone.