Palliative brachytherapy with or without primary stent placement in patients with oesophageal cancer, a randomised phase III trial

Cecilie Delphin Amdal, Anne-Birgitte Jacobsen, Berit Sandstad, Trond Warloe, Kristin Bjordal
2013 Radiotherapy and Oncology  
Purpose: To investigate whether a combination of self-expanding metal stent (SEMS) and brachytherapy provided more rapid and prolonged effect on dysphagia without increased pain compared to brachytherapy alone in patients with incurable oesophageal cancer. Methods: 41 Patients were randomised to SEMS followed by brachytherapy, 8 Gy 3 (n = 21) or brachytherapy alone, 8 Gy 3 (n = 20). Change in dysphagia and pain three and seven weeks after randomisation (FU1 and FU2) was assessed by
more » ... ted outcome. Dysphagia, other symptoms and healthrelated quality of life were assessed every four weeks thereafter. The study was closed before the estimated patient-number was reached due to slow recruitment. Results: Patients receiving SEMS followed by brachytherapy had significantly improved dysphagia at FU1 compared to patients receiving brachytherapy alone (n = 35). Difference in pain was not observed. At FU2, patients in both arms (n = 21) had less dysphagia. Four patients in the combined treatment arm experienced manageable complications, no complications occurred after brachytherapy alone. Conclusion: For the relief of dysphagia, SEMS followed by brachytherapy is preferable and safe for patients in need of immediate alleviation, while brachytherapy with or without preceding SEMS provides relief within a few weeks after treatment.
doi:10.1016/j.radonc.2013.04.008 pmid:23647761 fatcat:x73enu5rqzf2llo6wfgvuxm6zm