Superiority of Concurrent Chemo Radiation Over Sequential Chemo Radiotherapy for Palliation of Dysphagia in Carcinoma Esophagus, A Reterospective Study.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
Aim: Positive results of many Trials have incorporated concurrent and sequential chemo radiotherapy in treatment of inoperable carcinoma esophagus. But concurrent chemo radiation therapy is similar to that achieved by surgery alone. The main plea of concurrent chemoradiation in esophageal cancers is early regression and palliation of dysphagia for long time. The aim of this study to analyse the modalities of treatment available for palliation of dysphagia in carcinoma esophagus and determine the most effective option among them. Materials and Methods: Between September 2011 to December 2013,50 patients of esophageal cancers were treated in our institute, 25 patients in sequential and 25 in concurrent chemo radiotherapy arm. Swallowing function was assessed in these patients by the use of a swallowing-function scoring system. Results: Assessment of response in two arms were done for grade of dysphagia palliation, Complete Response at 6 months and toxicity. Dysphagia scores improved in 88% in study arm and 64% in control arm. In study arm 28% male and 52% female patients, while in control arm 40 % male and 28% female patients presented with CR in primary tumor and mediastinal lymph node. There was statistical significant difference in toxicities of TLC and ANC between both arms. Grade 2 and 3 toxicities were 40% and 4% for TLC and were 28% and 0% for ANC in study and control arm respectively (p = 0.013 ,p=.014). This may be due to concurrent use of chemotherapy with radiation in study arm that also showed synergism for toxicity of TLC and ANC. Conclusion: Concurrent Chemo Radiotherapy is a more aggressive approach for dysphagia control, which is beneficial for those patients with good performance status .This approach is used as an alternative to stenting. This combination is more effective than neoadjuvant chemoradiation for improving dysphagia scores and QoL in inoperable esophageal cancers .
Authors and Affiliations
Dr Pramila Kumari, Dr Praveen Kumar Khatri, Dr Saroj Kumari, Dr Mukesh Kumar Singhal, Dr Kamlesh Kumar Harsh, Dr Shankar Lal Jakhar, Dr Neeti Sharma, Dr HS Kumar
Keywords
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- EP ID EP600141
- DOI 10.9790/0853-1603091621.
- Views 56
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