Continuous hyperfractionated accelerated radiotherapy (CHART) in localized cancer of the esophagus.

To assess the efficacy and toxicity of continuous hyperfractionated accelerated radiotherapy (CHART) in locoregional control compared with a historical group of patients treated with conventionally fractionated radical radiotherapy.
Between 1985 and 1994, 54 patients with localized esophageal cancer were treated with CHART. Twenty-eight patients received CHART alone (54 Gy in 36 fractions over 12 consecutive days) and 15 were given intravenous mitomycin C and cisplatin on days 10 and 13, respectively. Eleven patients received 40.5 Gy in 27 fractions over 9 days, followed by a single high-dose-rate intraluminal brachytherapy insertion of 15 Gy at 1 cm.
Acute toxicity was well tolerated and dysphagia was improved in 35 patients (65%), with 28 (52%) eating a normal diet by week 12. This compares with an improvement in dysphagia score in 72% of the conventionally treated group. The median duration of relief of dysphagia was 7.8 months (range 0-41.4) in the CHART group compared with 5.5 months (range 0-48) in the controls. Strictures developed in 29 patients (61%) and 18 were confirmed on biopsy to be due to recurrent disease. Median survival was 12 months (range 0.5-112) in the CHART group and 15 months (range 3.6-56) in the control patients.
CHART is well tolerated and achieves a high rate of local control. Palliation in the short overall treatment time of esophageal cancer is an advantage in these patients whose median survival is only 12 months.
AuthorsM E Powell, P J Hoskin, M I Saunders, C J Foy, S Dische
JournalInternational journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 38 Issue 1 Pg. 133-6 (Apr 1 1997) ISSN: 0360-3016 [Print] UNITED STATES
PMID9212014 (Publication Type: Journal Article)
Chemical References
  • Mitomycin
  • Cisplatin
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Cause of Death
  • Cisplatin (administration & dosage)
  • Combined Modality Therapy
  • Deglutition Disorders (radiotherapy)
  • Disease-Free Survival
  • Esophageal Neoplasms (drug therapy, mortality, pathology, radiotherapy)
  • Esophagitis (etiology)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mitomycin (administration & dosage)
  • Radiotherapy Dosage

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