IDDF2019-ABS-0331 Intraluminal brachytherapy (ILBT) boost following concurrent chemoradiation in patients of inoperable oesophageal cancer – a single institute experience. (June 2019)

• Record Type: Journal Article
• Authors: Khosla, Divya; Kapoor, Rakesh; Madan, Renu; Rana, Sakshi; Oinam, Arun; Singh, Ranjit; Kumar, Narendra; Persamy, Kannan; Yadav, Budhi; Rana, Surinder; Gupta, Rajesh
• Is Part Of: Gut. Volume 68(2019)Supplement 1
• Page Start: A120
• Page End: A120
• Publication Date: 2019-06
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2019-IDDFAbstracts.235
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: Definitive concurrent chemoradiation is the standard of care for patients with inoperable oesophageal cancer. Intraluminal brachytherapy (ILBT) given as boost following concurrent chemoradiation increases the dose to tumor with sparing of adjacent normal structures. The aim of the present study was to analyse the response to concurrent chemoradiation followed by ILBT as a boost in inoperable oesophageal cancer patients. Methods: Twenty-two patients of carcinoma of the middle and lower oesophagus were included in the study. All patients received external beam radiotherapy of 40 Gy in 20 fractions over 4 weeks with concomitant chemotherapy with weekly cisplatin and 5-fluorouracil. Barium swallow and upper gastrointestinal endoscopy were performed for response assessment at 2 weeks post chemoradiation. The dose of brachytherapy was two fractions of 6 Gy delivered one week apart. Universal plastic bougie was inserted and a margin of 2 cm was given to residual tumor in superior and inferior direction. The dose was prescribed at 8 mm from midline and treatment was delivered by a high dose rate 60 Co source (figure 1 ). Response evaluation was done at 1 and at 3 months after treatment completion. Results: The patient and tumor characteristics are shown in table 1 (table 1 ). The treatment was well tolerated and all patients completed the prescribed course of therapy. The swallowing ability improved in all patients except one patient after a month of therapy. No patient developed grade 3 or higher toxicity. Dysphagia score at one month follow up was grade I in 10 patients and grade 2 in 3 patients. None of the patients had grade 3 or 4 dysphagia after treatment. The median follow-up was 11 months. Three patients had progression of disease with worsening of dysphagia. Four patients had dysphagia due to stricture which was relieved by endoscopic dilatation. Conclusions: ILBT can deliver high tumoricidal dose with potential improvement in the therapeutic control and better sparing of surrounding normal tissues.