Brachytherapy in the Palliation of Oesophageal Cancer: Effective but Impractical?

Abstract

Dysphagia in people with advanced oesophageal cancer can be treated by oesophageal stents, external beam radiotherapy (EBRT) and intraluminal brachytherapy. Despite guidelines recommending brachytherapy for patients with a predicted life expectancy exceeding 3 months, its uptake in the UK has been limited. Here we examine the strength of the evidence supporting the use of brachytherapy compared with oesophageal stents and EBRT and possible reasons for its limited uptake. Trials and observational studies suggest brachytherapy alone confers a benefit to patients, but its impact is less immediate than oesophageal stents; the evidence on effectiveness and value-for-money is limited. Moreover, stronger evidence will probably be insufficient to increase uptake, due to the extra complexity of delivery compared with stents and EBRT and a lack of experience among specialists.

• Authors: S Sinha, M Varagunam, M H Park, N D Maynard, N Trudgill, T Crosby, D A Cromwell
• Journal: Clinical oncology (Royal College of Radiologists (Great Britain)) (Clin Oncol (R Coll Radiol)) Vol. 31 Issue 7 Pg. e87-e93 (07 2019) ISSN: 1433-2981 [Electronic] England
• PMID: 30982667 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Brachytherapy (methods)
• Deglutition Disorders (radiotherapy)
• Esophageal Neoplasms (radiotherapy)
• Female
• Humans
• Male
• Middle Aged
• Palliative Care (methods)
• Young Adult