Lancet Sub-Journal: Radiotherapy does not help patients with advanced esophageal cancer with dysphagia!

Esophageal cancer is the most common gastrointestinal tumor.
About 300,000 people die from esophageal cancer every year worldwide
.

The survival period of patients with advanced esophageal cancer is only 3-6 months.

The Cardiff University team tested the effect of EBRT in adjuvant conventional treatment and found that EBRT did not bring any benefits, and even increased the risk of tumor bleeding

method

 

The experiment is a multi-center, open-label, phase 3 randomized controlled trial, conducted in cancer centers and acute care hospitals in England, Scotland and Wales
.

Patients with esophageal cancer (age>=16 years old) who received stent placement to treat dysphagia were randomly assigned to receive conventional treatment or EBRT (20Gy in 5 times or 30Gy in 10 times) plus conventional treatment for post-stent care

The main result of concern was the difference in the proportion of participants who had worsening dysphagia or died for more than 12 weeks
.

The experiment used the European Organization for Cancer Research and Treatment Quality of Life Questionnaire-Esophagus and Stomach Module (QLQ-OG25), and worsening dysphagia was defined as a score reduction> 11 points or occurrence of a dysphagia event equivalent to worsening

 

result

 

During the period from December 16, 2013 to August 24, 2018, 220 patients from 23 British medical centers were randomly assigned, and the people who intended to receive treatment (ITT, n=199) were divided into the conventional treatment group ( n=102) and EBRT group (n=97)
.

The results showed that radiotherapy did not reduce the worsening of dysphagia (36/74 (49%) in the conventional treatment group vs.

Radiotherapy did not reduce the exacerbation of dysphagia.

Table 1: DDFS (the number of people with worsening swallowing-the number of survivors) and the total number of survivors

Summarize

 

For patients with advanced esophageal cancer who have received SEMS metal stent insertion, current palliative radiotherapy does not bring any additional benefits, and therefore should not be provided as an effective means
.

For some patients, palliative radiotherapy will increase the risk of tumor bleeding

For patients with advanced esophageal cancer who have received SEMS metal stent insertion, current palliative radiotherapy does not bring any additional benefits, and therefore should not be provided as an effective means

references:

Adamson D, Byrne A, Porter C et.

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