Prospective randomized comparative study between EBRT alone and EBRT with ILRT boost in locally advanced unresectable esophageal cancer - Tertiary rural Indian cancer center experience

Authors

  • Pinky Sarahiya Senior Resident, Department of Radiation Oncology, State Cancer Institute, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India https://orcid.org/0009-0003-6535-5750
  • Shyamji Rawat Professor, Department of Radiation Oncology, State Cancer Institute, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India https://orcid.org/0000-0002-3757-5401
  • Lalit M Patel Assistant Professor, Department of Radiation Oncology, State Cancer Institute, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India https://orcid.org/0000-0002-3865-0901
  • Hitesh Sharma Associate Professor, Department of Radiation Oncology, State Cancer Institute, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India https://orcid.org/0000-0001-6882-0281
  • Laxmi Singotia Professor, Department of Radiation Oncology, State Cancer Institute, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India https://orcid.org/0000-0002-3994-3124
  • Rajesh Kumar Jain Associate Professor, Department of Radiation Oncology, State Cancer Institute, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India https://orcid.org/0000-0002-6379-0893
  • Arkojyoti Raychaudhuri Fellow, Department of Clinical Oncology, Tata Memorial Centre, Kolkata, West Bengal, India https://orcid.org/0009-0006-6521-567X

DOI:

https://doi.org/10.3126/ajms.v15i3.60359

Keywords:

Esophageal cancer; Concurrent chemoradiotherapy; Radiotherapy dose; Standard dose; High dose

Abstract

Background: Local recurrence within the gross tumor volume following a conventional radiation dose of 50 Gy is a major hurdle in achieving a better prognosis for esophageal carcinoma. Consequently, there remains a lack of consensus globally regarding the optimal dose for definitive concurrent chemoradiotherapy. Certain studies propose that radiation dose escalation could enhance clinical outcomes.

Aims and Objectives: The current study aimed to compare the safety and effectiveness of external beam radiotherapy (EBRT) alone versus EBRT with intraluminal radiotherapy (ILRT) boost.

Materials and Methods: A total of 60 patients with locally advanced unresectable squamous cell carcinoma of the esophagus were prospectively enrolled in this study. A comparison was conducted between 50 Gy EBRT alone and 50 Gy EBRT with 8 Gy ILRT boost, alongside weekly concurrent chemotherapy, to assess the response and toxicities.

Results: On initial assessment, a complete response (CR) was achieved in 76.66% of patients in the ILRT boost arm and 70% in the EBRT alone arm (P=0.559). At the 6th-month follow-up, 60% of patients in the ILRT boost arm and 50% in the EBRT alone arm still had a CR. No statistically significant differences were observed between the two arms in terms of leukopenia (P=0.576), nephrotoxicity (P=1.0), radiation dermatitis (P=0.615), vomiting (P=0.921), and diarrhea (P=1.0). Five patients in the ILRT boost arm and three in the EBRT alone arm experienced stricture, while no cases of fistula formation were reported.

Conclusion: Dose escalation with ILRT can result in an enhanced CR accompanied by manageable toxicity, ultimately leading to improved locoregional control.

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Published

2024-03-01

How to Cite

Sarahiya, P., Rawat, S., Patel, L. M., Sharma , H. ., Singotia, L. ., Jain, R. K. ., & Raychaudhuri , A. (2024). Prospective randomized comparative study between EBRT alone and EBRT with ILRT boost in locally advanced unresectable esophageal cancer - Tertiary rural Indian cancer center experience. Asian Journal of Medical Sciences, 15(3), 161–167. https://doi.org/10.3126/ajms.v15i3.60359

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Original Articles