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

Abstract

PURPOSE:

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.

METHODS AND MATERIALS:

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.

RESULTS:

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.

CONCLUSION:

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.

• Authors: M E Powell, P J Hoskin, M I Saunders, C J Foy, S Dische
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 38 Issue 1 Pg. 133-6 (Apr 01 1997) ISSN: 0360-3016 [Print] United States
• PMID: 9212014 (Publication Type: Journal Article)

Chemical References

• Mitomycin
• Cisplatin

Topics

• 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