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Brachytherapy for Oesophageal Carcinoma: A Comprehensive Review of Literature and Techniques

Published online by Cambridge University Press:  18 January 2021

Rashi Kulshrestha ,
Anil Gupta Open the ORCID record for Anil Gupta [Opens in a new window] ,
Daya Nand Sharma  and
Kishore Singh
Rashi Kulshrestha
Affiliation:
Radiation Oncology, BC Cancer Agency, Abbotsford, British Columbia, BC V2S 0C2, Canada
Anil Gupta*
Affiliation:
Radiation Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, 110029, India
Daya Nand Sharma
Affiliation:
Radiation Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, 110029, India
Kishore Singh
Affiliation:
Radiation Oncology, Maulana Azad Medical College, New Delhi, Delhi, 110002, India
*
Author for correspondence: Anil Gupta, Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi, 110029, India. E-mail: [email protected]
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Abstract

Introduction:

Oesophageal carcinoma is one of the fatal cancers mainly because of its rapid spread and poor prognosis. Treatment modalities involves a multimodality approach, including surgery, radiation therapy and chemotherapy. Radiation therapy includes brachytherapy in the form of intraluminal radiation therapy. Brachytherapy permits delivery of high tumouricidal doses to superficial cancerous growth of the oesophagus while delivering much lower doses to the surrounding tissue. It is mostly given in combination with external beam radiation in patients with poor performance scores not likely to tolerate an aggressive chemoradiation regimen or as a boost to concurrent chemoradiotherapy. It is very effective in terms of local tumour control as well as in relieving symptoms in advanced/recurrent disease. Intraoperative brachytherapy and seed brachytherapy have also been tried to address the nodal disease.

Methods:

We undertook a review of the available literature and techniques developed in the past three decades to emphasise the role of brachytherapy in curative or palliative settings in the treatment of oesophageal carcinoma.

Conclusion:

Oesophageal brachytherapy will remain a tangible treatment of oesophageal cancer, although it is less commonly used due to high expertise requirement, lack of established evidence, risk of life-threatening complications and lack of interest in brachytherapy. It offers quick and useful palliation for a prolonged period, along with good quality of life and superior dosimetry. Use of novel applicators may allow dose escalation and lower toxicity. Seed brachytherapy is also emerging as a promising option in nodal recurrences.

Keywords

brachytherapy applicatorsoesophageal cancerintraluminal radiation therapy (ILRT)intraoperative brachytherapyseed brachytherapy
Type
Literature Review
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 2 , June 2022 , pp. 267 - 276
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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