Chemoradiation therapy is effective for the palliative treatment of malignant dysphagia

JA Harvey, Bessell, E Beller, J Thomas, DC Gotley, BH Burmeister, ET Walpole, DB Thomson, I Martin, L Doyle, E Burmeister, BM Smithers

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Abstract

Between 1993 and 2001, 106 patients with esophageal cancer were reviewed at a multidisciplinary clinic and treated with palliative intent by chemoradiation therapy. This study assesses the palliative benefit on dysphagia and documents the toxicity of this treatment. The study population comprised 72 men and 34 women with a median age of 69 years. Patients were treated with a median radiation dose of 35 Gy in 15 fractions with a concurrent single course of 5 FU-based chemotherapy. Dysphagia was measured at the beginning and completion of treatment and at monthly intervals until death, using a modified DeMeester (4-point) score. Treatment was well tolerated, with only 5% of patients failing to complete therapy. The treatment-related mortality was 6%. The median survival for the study population was 7 months. The median baseline score at presentation was 2 (difficulty with soft food). Following treatment, 49% of patients were assessed as having a dysphagia score of 0 (no dysphagia). Seventy-eight per cent had an improvement of at least one grade in their dysphagia score after treatment. Only 14% of patients showed no improvement with treatment. Fifty-one per cent maintained improved swallowing until the time of last follow-up or death. This single-institution study shows that chemoradiation therapy administered for the palliation of malignant dysphagia is well tolerated and produces a sustainable normalization in swallowing for almost half of all patients.

Original languageEnglish
Pages (from-to)260-265
Number of pages6
JournalDiseases of the Esophagus
Volume17
Issue number3
DOIs
Publication statusPublished - 2004
Externally publishedYes

Cite this

Harvey, JA ; Bessell, ; Beller, E ; Thomas, J ; Gotley, DC ; Burmeister, BH ; Walpole, ET ; Thomson, DB ; Martin, I ; Doyle, L ; Burmeister, E ; Smithers, BM. / Chemoradiation therapy is effective for the palliative treatment of malignant dysphagia. In: Diseases of the Esophagus. 2004 ; Vol. 17, No. 3. pp. 260-265.
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abstract = "Between 1993 and 2001, 106 patients with esophageal cancer were reviewed at a multidisciplinary clinic and treated with palliative intent by chemoradiation therapy. This study assesses the palliative benefit on dysphagia and documents the toxicity of this treatment. The study population comprised 72 men and 34 women with a median age of 69 years. Patients were treated with a median radiation dose of 35 Gy in 15 fractions with a concurrent single course of 5 FU-based chemotherapy. Dysphagia was measured at the beginning and completion of treatment and at monthly intervals until death, using a modified DeMeester (4-point) score. Treatment was well tolerated, with only 5{\%} of patients failing to complete therapy. The treatment-related mortality was 6{\%}. The median survival for the study population was 7 months. The median baseline score at presentation was 2 (difficulty with soft food). Following treatment, 49{\%} of patients were assessed as having a dysphagia score of 0 (no dysphagia). Seventy-eight per cent had an improvement of at least one grade in their dysphagia score after treatment. Only 14{\%} of patients showed no improvement with treatment. Fifty-one per cent maintained improved swallowing until the time of last follow-up or death. This single-institution study shows that chemoradiation therapy administered for the palliation of malignant dysphagia is well tolerated and produces a sustainable normalization in swallowing for almost half of all patients.",
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Harvey, JA, Bessell, , Beller, E, Thomas, J, Gotley, DC, Burmeister, BH, Walpole, ET, Thomson, DB, Martin, I, Doyle, L, Burmeister, E & Smithers, BM 2004, 'Chemoradiation therapy is effective for the palliative treatment of malignant dysphagia' Diseases of the Esophagus, vol. 17, no. 3, pp. 260-265. https://doi.org/10.1111/j.1442-2050.2004.00420.x

Chemoradiation therapy is effective for the palliative treatment of malignant dysphagia. / Harvey, JA; Bessell, ; Beller, E; Thomas, J; Gotley, DC; Burmeister, BH; Walpole, ET; Thomson, DB; Martin, I ; Doyle, L; Burmeister, E; Smithers, BM.

In: Diseases of the Esophagus, Vol. 17, No. 3, 2004, p. 260-265.

Research output: Contribution to journalArticleResearchpeer-review

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AB - Between 1993 and 2001, 106 patients with esophageal cancer were reviewed at a multidisciplinary clinic and treated with palliative intent by chemoradiation therapy. This study assesses the palliative benefit on dysphagia and documents the toxicity of this treatment. The study population comprised 72 men and 34 women with a median age of 69 years. Patients were treated with a median radiation dose of 35 Gy in 15 fractions with a concurrent single course of 5 FU-based chemotherapy. Dysphagia was measured at the beginning and completion of treatment and at monthly intervals until death, using a modified DeMeester (4-point) score. Treatment was well tolerated, with only 5% of patients failing to complete therapy. The treatment-related mortality was 6%. The median survival for the study population was 7 months. The median baseline score at presentation was 2 (difficulty with soft food). Following treatment, 49% of patients were assessed as having a dysphagia score of 0 (no dysphagia). Seventy-eight per cent had an improvement of at least one grade in their dysphagia score after treatment. Only 14% of patients showed no improvement with treatment. Fifty-one per cent maintained improved swallowing until the time of last follow-up or death. This single-institution study shows that chemoradiation therapy administered for the palliation of malignant dysphagia is well tolerated and produces a sustainable normalization in swallowing for almost half of all patients.

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