Definitive chemo-radiotherapy in cervical oesophageal cancer: a comprehensive review of literature.

IF 1.2 Q4 ONCOLOGY
Reports of Practical Oncology and Radiotherapy Pub Date : 2024-07-22 eCollection Date: 2024-01-01 DOI:10.5603/rpor.100777
Ankita Mehta, Rohit Avinash Vadgaonkar, Shirley Lewis, Umesh Mahantshetty, J P Agarwal
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Abstract

Background and objectives: Despite decades of experience with definitive chemo-radiotherapy (CRT) in cervical oesophageal cancer (CEC), the loco-regional control and survival outcomes are dismal. This review evaluated the outcomes of various treatment strategies being commonly utilized.

Materials and methods: A literature review was conducted to identify relevant articles on CEC published from years 2000-2023 addressing the predefined key questions. These questions focussed on the comparative outcomes of various primary treatment approaches (surgery, CRT, or trimodality treatment) and the radiation dose schedules, volumes, and techniques.

Results: CRT is the standard approach for treatment for CEC so far. The potential role of surgery and trimodality approach in settings of evolving surgical approaches needs to be validated. The high dose schedules that are preferentially practiced in CEC have not shown any benefit in improving the disease outcomes over the standard dose schedule of 50.4 Gy. The target volume delineation practice of elective nodal irradiation (ENI) does not have a proven benefit over the involved field irradiation (IFI). The limited evidence on radiation techniques suggests that intensity-modulated radiotherapy/volumetric-modulated arc therapy (IMRT/VMAT) techniques can improve toxicity profile over three-dimensional conformal radiotherapy (3DCRT), but no advantage proven in disease outcomes so far.

Conclusion: This review will guide clinicians in decision-making for the management of this relatively rare entity and the directions for future research in these areas. Future large-scale multicentre prospective studies are needed for validating and standardizing our current practices and exploring potential options to improve the outcomes.

宫颈食道癌的确定性放化疗:文献综述。
背景和目的:尽管宫颈食管癌(CEC)的确定性化疗放疗(CRT)已有几十年的经验,但局部区域控制和生存结果却令人沮丧。本综述评估了目前常用的各种治疗策略的效果:我们进行了文献综述,以确定 2000-2023 年间发表的有关 CEC 的相关文章,并回答了预先确定的关键问题。这些问题集中在各种主要治疗方法(手术、CRT 或三联疗法)以及放射剂量计划、剂量和技术的比较结果上:结果:迄今为止,CRT 是治疗 CEC 的标准方法。结果:迄今为止,CRT 是治疗 CEC 的标准方法。在手术方法不断发展的情况下,手术和三联疗法的潜在作用有待验证。与 50.4 Gy 的标准剂量相比,CEC 首选的高剂量方案在改善疾病预后方面并未显示出任何益处。与介入野照射(IFI)相比,选择性结节照射(ENI)的靶体积划定实践并未证明有任何益处。放疗技术方面的有限证据表明,调强放疗/容积调强弧形放疗(IMRT/VMAT)技术与三维适形放疗(3DCRT)相比,可以改善毒性状况,但迄今为止尚未证实在疾病预后方面有任何优势:本综述将指导临床医生对这一相对罕见的疾病做出治疗决策,并为这些领域的未来研究指明方向。未来需要开展大规模多中心前瞻性研究,以验证和规范我们目前的做法,并探索改善疗效的潜在方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.80
自引率
8.30%
发文量
115
审稿时长
16 weeks
期刊介绍: Reports of Practical Oncology and Radiotherapy is an interdisciplinary bimonthly journal, publishing original contributions in clinical oncology and radiotherapy, as well as in radiotherapy physics, techniques and radiotherapy equipment. Reports of Practical Oncology and Radiotherapy is a journal of the Polish Society of Radiation Oncology, the Czech Society of Radiation Oncology, the Hungarian Society for Radiation Oncology, the Slovenian Society for Radiotherapy and Oncology, the Polish Study Group of Head and Neck Cancer, the Guild of Bulgarian Radiotherapists and the Greater Poland Cancer Centre, affiliated with the Spanish Society of Radiotherapy and Oncology, the Italian Association of Radiotherapy and the Portuguese Society of Radiotherapy - Oncology.
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