Assessment of the efficacy of external beam radiotherapy followed by intraluminal brachytherapy in palliation of dysphagia in patients with carcinoma esophagus: A single arm prospective study

Kalaiyarasi PURPOSE: The prognosis of esophageal cancer remains poor, inspite of advances in treatment techniques, owing to the high incidence of local recurrence and distant metastases in more than 50% of patients. Various methods of palliation have been used in an attempt to improve patients’ quality of life and to provide near normal, if not normal, swallowing until death occurs because of progressive systemic disease. The addition of intraluminal brachytherapy to external beam radiation has shown significant improvement in dysphagia relief and symptom scores. The aim of the present study was to evaluate the efficacy of combined use of external beam radiation and intraluminal brachytherapy. MATERIALS AND METHODS: This single arm prospective study conducted in department of radiotherapy between October 2016 to august 2017 with sample size of 30 with unresectable advanced esophageal cancer. Median age was 58. Mostly male patients with ECOG 2. All patients received 30 Gy External Beam Radiation followed by 2 fractions intraluminal brachytherapy 8Gy one week apart. Patients were assessed for symptom scores of dysphagia. comparison of pretreatment and posttreatment dysphagia scores were made. RESULTS: For Median follow up of 6 months. Median dysphagia score improved from 3 to 2 after 4 weeks of HDR brachytherapy. Overall 22 patients had improvement in dysphagia score and 12 out of 30 had dysphagia free survival. Complications were esophagitis, stricture and fistula. CONCLUSION: This study showed combination of external beam radiation and High dose rate brachytherapy can produce acceptable dysphagia relief