Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort study
Abstract Background Common symptoms of oesophageal cancer are dysphagia, pain, and bleeding. These symptoms can be relieved with palliative radiotherapy. The aim of this study was to analyse the outcome of two different palliative radiotherapy schedules. Methods We conducted a retrospective cohort s...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-021-01880-9 |
| _version_ | 1818645004145393664 |
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| author | Halla Sif Ólafsdóttir Fredrik Klevebro Nelson Ndegwa Gabriella Alexandersson von Döbeln |
| author_facet | Halla Sif Ólafsdóttir Fredrik Klevebro Nelson Ndegwa Gabriella Alexandersson von Döbeln |
| author_sort | Halla Sif Ólafsdóttir |
| collection | DOAJ |
| description | Abstract Background Common symptoms of oesophageal cancer are dysphagia, pain, and bleeding. These symptoms can be relieved with palliative radiotherapy. The aim of this study was to analyse the outcome of two different palliative radiotherapy schedules. Methods We conducted a retrospective cohort study on palliative radiotherapy for oesophageal cancer given at Karolinska University Hospital. Patients included were treated with either short-course (20 Gy in 4 Gy fractions daily, 5 consecutive workdays) or long-course (30–39 Gy in 3 Gy fractions, 10–13 consecutive workdays) palliative external beam radiotherapy between January 2009 and December 2013. The primary endpoint was dysphagia relief and secondary endpoints were adverse events, re-interventions, and overall survival. Cox regression analyses were used to estimate the effect of treatment schedule on survival. Results A total of 128 patients received external beam radiotherapy under the study period, of these 75 (58.6%) received short-course radiotherapy and 53 (41.4%) long-course radiotherapy. Sixteen (30.8%) patients experienced dysphagia relief after short-course radiotherapy and 9 (22.0%) patients after long-course radiotherapy (p = 0.341). Acute toxicity was less frequent after short-course radiotherapy than after long-course radiotherapy, particularly oesophagitis (35.4% vs. 56.0%, p = 0.027) and nausea/emesis (18.5% vs. 36.0% p = 0.034). Re-interventions tended to be more common after short-course radiotherapy (32.0%) than after long-course radiotherapy (18.9%) (p = 0.098). There was no difference in overall survival between the two groups. Conclusions Short- and long-course palliative radiotherapy for oesophageal cancer were equally effective to relieve dysphagia and no difference was seen in overall survival. Acute toxicity was, however, more frequent and more severe after long-course radiotherapy. Our results suggest that short-course radiotherapy is better tolerated with equal palliative effects as long-course radiotherapy. |
| first_indexed | 2024-12-17T00:23:51Z |
| format | Article |
| id | doaj.art-6672d6874acb40118725dfce98cf91b9 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-17T00:23:51Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-6672d6874acb40118725dfce98cf91b92022-12-21T22:10:31ZengBMCRadiation Oncology1748-717X2021-08-0116111010.1186/s13014-021-01880-9Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort studyHalla Sif Ólafsdóttir0Fredrik Klevebro1Nelson Ndegwa2Gabriella Alexandersson von Döbeln3Department of Clinical Science, Intervention and Technology, Karolinska InstitutetDepartment of Clinical Science, Intervention and Technology, Karolinska InstitutetDepartment of Clinical Science, Intervention and Technology, Karolinska InstitutetDepartment of Clinical Science, Intervention and Technology, Karolinska InstitutetAbstract Background Common symptoms of oesophageal cancer are dysphagia, pain, and bleeding. These symptoms can be relieved with palliative radiotherapy. The aim of this study was to analyse the outcome of two different palliative radiotherapy schedules. Methods We conducted a retrospective cohort study on palliative radiotherapy for oesophageal cancer given at Karolinska University Hospital. Patients included were treated with either short-course (20 Gy in 4 Gy fractions daily, 5 consecutive workdays) or long-course (30–39 Gy in 3 Gy fractions, 10–13 consecutive workdays) palliative external beam radiotherapy between January 2009 and December 2013. The primary endpoint was dysphagia relief and secondary endpoints were adverse events, re-interventions, and overall survival. Cox regression analyses were used to estimate the effect of treatment schedule on survival. Results A total of 128 patients received external beam radiotherapy under the study period, of these 75 (58.6%) received short-course radiotherapy and 53 (41.4%) long-course radiotherapy. Sixteen (30.8%) patients experienced dysphagia relief after short-course radiotherapy and 9 (22.0%) patients after long-course radiotherapy (p = 0.341). Acute toxicity was less frequent after short-course radiotherapy than after long-course radiotherapy, particularly oesophagitis (35.4% vs. 56.0%, p = 0.027) and nausea/emesis (18.5% vs. 36.0% p = 0.034). Re-interventions tended to be more common after short-course radiotherapy (32.0%) than after long-course radiotherapy (18.9%) (p = 0.098). There was no difference in overall survival between the two groups. Conclusions Short- and long-course palliative radiotherapy for oesophageal cancer were equally effective to relieve dysphagia and no difference was seen in overall survival. Acute toxicity was, however, more frequent and more severe after long-course radiotherapy. Our results suggest that short-course radiotherapy is better tolerated with equal palliative effects as long-course radiotherapy.https://doi.org/10.1186/s13014-021-01880-9Oesophageal neoplasmPalliative careRadiotherapyDose fractionationDysphagia |
| spellingShingle | Halla Sif Ólafsdóttir Fredrik Klevebro Nelson Ndegwa Gabriella Alexandersson von Döbeln Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort study Radiation Oncology Oesophageal neoplasm Palliative care Radiotherapy Dose fractionation Dysphagia |
| title | Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort study |
| title_full | Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort study |
| title_fullStr | Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort study |
| title_full_unstemmed | Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort study |
| title_short | Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort study |
| title_sort | short course compared to long course palliative radiotherapy for oesophageal cancer a single centre observational cohort study |
| topic | Oesophageal neoplasm Palliative care Radiotherapy Dose fractionation Dysphagia |
| url | https://doi.org/10.1186/s13014-021-01880-9 |
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