Palliative external beam radiotherapy to the oesophagus – a single centre evaluation


Year:

Session type:

VS Kumar1, OS Din2, JC Wadsley1

1Dept of Clinical Oncology, Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, UK, 2Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Sheffield, South Yorkshire, UK

Abstract

Background

Patients with oesophageal cancer often have distressing gastrointestinal symptoms affecting their quality of life. Palliative radiotherapy has long been used in this situation but there is little published evidence on its efficacy.

Aim

The aim of the study was to retrospectively evaluate the benefit of palliative radiotherapy to the oesophagus.

Method

Patients’ who received radiotherapy between 2005-2007 were identified and data was collected on stage, histology, performance status (PS), indication, radiotherapy details, stent insertion, symptom response and survival. Analysis was performed using SPSS (v15).

Results         

56% were males and 44% females. The median age at the start of radiotherapy was 76 (range 54 to 92). 88% had locally advanced disease; Adenocarcinoma was the predominant histology (68%), although 32% had squamous differentiation. 46% were PS 2. In 90%, the main indication for radiotherapy was pain and/or dysphagia. 20Gy in 5 fractions was the most commonly used palliative fractionation schedule. However, single fraction treatment (8 or 10 Gy) was used when bleeding was the main presenting complaint, usually in those with PS 3. Of the 50 patients who were evaluated, 74%(37/50) had evidence of symptomatic benefit. Pre-radiotherapy stent insertion was noted in 8%(4/50) of patients. 26% (13/50) required a stent following radiotherapy. The median time to stenting was 138 days. Median overall survival from the start of radiotherapy was 6.3 months.

Conclusion

This short palliative radiotherapy regime seems to be highly effective in alleviating symptoms. There is a need to evaluate this further in a prospective study, with particular reference to effects on quality of life.

Background

Patients with oesophageal cancer often have distressing gastrointestinal symptoms affecting their quality of life. Palliative radiotherapy has long been used in this situation but there is little published evidence on its efficacy.

Aim

The aim of the study was to retrospectively evaluate the benefit of palliative radiotherapy to the oesophagus.

Method

Patients’ who received radiotherapy between 2005-2007 were identified and data was collected on stage, histology, performance status (PS), indication, radiotherapy details, stent insertion, symptom response and survival. Analysis was performed using SPSS (v15).

Results         

56% were males and 44% females. The median age at the start of radiotherapy was 76 (range 54 to 92). 88% had locally advanced disease; Adenocarcinoma was the predominant histology (68%), although 32% had squamous differentiation. 46% were PS 2. In 90%, the main indication for radiotherapy was pain and/or dysphagia. 20Gy in 5 fractions was the most commonly used palliative fractionation schedule. However, single fraction treatment (8 or 10 Gy) was used when bleeding was the main presenting complaint, usually in those with PS 3. Of the 50 patients who were evaluated, 74%(37/50) had evidence of symptomatic benefit. Pre-radiotherapy stent insertion was noted in 8%(4/50) of patients. 26% (13/50) required a stent following radiotherapy. The median time to stenting was 138 days. Median overall survival from the start of radiotherapy was 6.3 months.

Conclusion

This short palliative radiotherapy regime seems to be highly effective in alleviating symptoms. There is a need to evaluate this further in a prospective study, with particular reference to effects on quality of life.