Is surgery necessary following chemoradiation for patients with locally advanced cancer of the esophagus?

2007 ◽  
Vol 4 (9) ◽  
pp. 506-507 ◽  
Author(s):  
Dirk Rades ◽  
Steven E Schild
Keyword(s):  
Advanced Cancer ◽  
Locally Advanced ◽  
Cancer Of The Esophagus ◽  
Locally Advanced Cancer

scholarly journals Dosimetric Comparison between High Dose Rate Brachytherapy Boost and Volumetric Arc Therapy Boost in Locally Advanced Cancer Cervix

2021 ◽  
Vol 07 (02) ◽  
pp. 085-088
Author(s):  
Hanady Hegazy ◽  
Neamat Hegazy ◽  
Maher Soliman ◽  
Amr Elsaid
Keyword(s):  
Small Bowel ◽  
Dose Rate ◽  
Advanced Cancer ◽  
Locally Advanced ◽  
Target Volume ◽  
High Dose Rate ◽  
High Dose ◽  
Cancer Cervix ◽  
Arc Therapy ◽  
Locally Advanced Cancer

AbstractConcurrent chemoradiotherapy is considered the standard treatment for the locally advanced cancer cervix (LACC). Radiotherapy is commonly administered by a three-dimensional conformal radiotherapy (3DCRT) approach followed by brachytherapy (BT). High dose rate (HDR) BT is commonly administered; however, several drawbacks exist including invasive technique, pain, requirement of anesthesia, and operative risks. We assessed the dosimetric difference between the HDR BT and the volumetric modulated arc therapy (VMAT) boost in those patients. Ten patients were selected retrospectively with LACC and all received whole pelvis radiotherapy followed by BT boost of 7 Gy in three fractions. The computed tomography (CT) image was transferred to the Varian system for the VMAT plan while the one with the applicator was transferred to the Sagi planning system and the high-risk clinical target volume (HR-CTV), bladder, rectum, sigmoid, and small bowel were delineate with a margin of 5 mm were added to the CTV to create the planning target volume (PTV). The D90 for the PTV in VMAT boost was lower than received by the HR-CTV in the BT boost. Mean volume of the PTV was higher than that of the HR-CTV. The D2cc was higher in VMAT for bladder, sigmoid, and rectum while the D2cc for the small bowel in BT was higher compared with the VMAT. The VMAT is an option that exists for patients who refuse BT or cannot tolerate it, or in case of nonavailability of BT or a nonworking machine.

scholarly journals EP-1484 Neoadjuvant CT followed by chemoradiation in locally advanced cancer cervix : feasibility and QOL study

2019 ◽  
Vol 133 ◽  
pp. S804-S805
Author(s):  
S. Singh ◽  
S. Sadhan Sarangi ◽  
P. Misra ◽  
D. Kapoor ◽  
A. Rani ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Locally Advanced ◽  
Cancer Cervix ◽  
Locally Advanced Cancer

scholarly journals Neoadjuvant cryotherapy improves dysphagia and may impact remission rates in advanced esophageal cancer

2019 ◽  
Vol 07 (11) ◽  
pp. E1522-E1527 ◽  
Author(s):  
Tilak Shah ◽  
Vladimir Kushnir ◽  
Pritesh Mutha ◽  
Mankanchan Majhail ◽  
Bhaumik Patel ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Advanced Cancer ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Synergistic Effects ◽  
Locally Advanced ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Dysphagia Score ◽  
Locally Advanced Cancer

Abstract Background and study aims Liquid nitrogen spray cryotherapy (LNSC) can provide rapid dysphagia relief, and is postulated to stimulate a local antitumor immune response. The aim of this prospective pilot clinical trial was to evaluate the safety and efficacy of LNSC when administered prior to chemoradiotherapy. Patients and methods Treatment-naïve adult patients with dysphagia at the time of biopsy-proven squamous carcinoma or adenocarcinoma of the esophagus were prospectively enrolled at two tertiary medical centers. Patients underwent a single session of LNSC. The primary outcome measure was change in dysphagia at 1 and 2 weeks post-cryotherapy. A secondary outcome measure was clinical complete response rate (CR) following chemoradiotherapy. Results Twenty-five patients were screened, of whom 21 patients were eligible and enrolled. There were seven with metastatic and 14 with locally advanced cancer. The primary outcome of dysphagia improvement of ≥ 1 point occurred in 15/21 patients (71 %) at 1 week, and 10/20 patients (50 %) at 2 weeks. The median dysphagia score improved by 1 at 1 week (P = 0.0003), and 0.5 at 2 weeks (P = 0.02). Six of nine patients (67 %) with locally advanced cancer who completed chemoradiation did not have residual tumor cells on mucosal biopsy, and five of nine patients (56 %) had a clinical CR. There were no serious cryotherapy-related complications. Conclusions LNSC provided safe and effective palliation for esophageal cancer patients who presented with dysphagia at index diagnosis. Its combination with chemoradiotherapy did not lead to any serious toxicity. Our study provides a scientific rationale for pursuing larger clinical trials addressing synergistic effects of combining LNSC with chemoradiation.

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