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Palliative short-course hypofractionated radiotherapy followed by chemotherapy in esophageal adenocarcinoma : the phase II PALAESTRA trial

Borg, David LU ; Sundberg, Jan ; Brun, Eva LU ; Kjellén, Elisabeth LU ; Petersson, Kristoffer LU ; Hermansson, Michael LU ; Johansson, Jan LU ; Eberhard, Jakob LU and Johnsson, Anders LU (2020) In Acta Oncologica 59(2). p.212-218
Abstract

Background: The majority of patients with incurable esophageal adenocarcinoma suffer from dysphagia. We assessed a novel treatment strategy with initial short-course radiotherapy followed by chemotherapy with the primary aim to achieve long-term relief of dysphagia. Methods: This phase II trial included treatment-naîve patients with dysphagia due to esophageal adenocarcinoma not eligible for curative treatment. External beam radiotherapy with 20 Gy in five fractions to the primary tumor was followed by four cycles of chemotherapy (FOLFOX regimen). Dysphagia was assessed using a five-grade scale. Results: From October 2014 to May 2018 a total of 29 patients were enrolled. The rate of dysphagia improvement was 79%, median duration of... (More)

Background: The majority of patients with incurable esophageal adenocarcinoma suffer from dysphagia. We assessed a novel treatment strategy with initial short-course radiotherapy followed by chemotherapy with the primary aim to achieve long-term relief of dysphagia. Methods: This phase II trial included treatment-naîve patients with dysphagia due to esophageal adenocarcinoma not eligible for curative treatment. External beam radiotherapy with 20 Gy in five fractions to the primary tumor was followed by four cycles of chemotherapy (FOLFOX regimen). Dysphagia was assessed using a five-grade scale. Results: From October 2014 to May 2018 a total of 29 patients were enrolled. The rate of dysphagia improvement was 79%, median duration of improvement 6.7 months (12.2 months for responders) and median overall survival 9.9 months. In the pre-specified per protocol analysis (23 patients) the rate of dysphagia improvement was 91%, median duration of improvement 12.2 months (14.0 months for responders) and median overall survival 16.0 months. The most common grade 3–4 adverse events were neutropenia (29%), infection (25%), anorexia (11%), esophagitis (11%) and fatigue (11%). Conclusion: Initial palliative short-course radiotherapy followed by chemotherapy is a promising treatment strategy that can provide long-lasting relief of dysphagia in patients with esophageal adenocarcinoma.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Oncologica
volume
59
issue
2
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • pmid:31564184
  • scopus:85073954717
ISSN
0284-186X
DOI
10.1080/0284186X.2019.1670861
language
English
LU publication?
yes
id
bff2726b-2356-4f02-b0bf-a3bef1086830
date added to LUP
2019-11-06 13:10:48
date last changed
2024-03-04 07:33:39
@article{bff2726b-2356-4f02-b0bf-a3bef1086830,
  abstract     = {{<p>Background: The majority of patients with incurable esophageal adenocarcinoma suffer from dysphagia. We assessed a novel treatment strategy with initial short-course radiotherapy followed by chemotherapy with the primary aim to achieve long-term relief of dysphagia. Methods: This phase II trial included treatment-naîve patients with dysphagia due to esophageal adenocarcinoma not eligible for curative treatment. External beam radiotherapy with 20 Gy in five fractions to the primary tumor was followed by four cycles of chemotherapy (FOLFOX regimen). Dysphagia was assessed using a five-grade scale. Results: From October 2014 to May 2018 a total of 29 patients were enrolled. The rate of dysphagia improvement was 79%, median duration of improvement 6.7 months (12.2 months for responders) and median overall survival 9.9 months. In the pre-specified per protocol analysis (23 patients) the rate of dysphagia improvement was 91%, median duration of improvement 12.2 months (14.0 months for responders) and median overall survival 16.0 months. The most common grade 3–4 adverse events were neutropenia (29%), infection (25%), anorexia (11%), esophagitis (11%) and fatigue (11%). Conclusion: Initial palliative short-course radiotherapy followed by chemotherapy is a promising treatment strategy that can provide long-lasting relief of dysphagia in patients with esophageal adenocarcinoma.</p>}},
  author       = {{Borg, David and Sundberg, Jan and Brun, Eva and Kjellén, Elisabeth and Petersson, Kristoffer and Hermansson, Michael and Johansson, Jan and Eberhard, Jakob and Johnsson, Anders}},
  issn         = {{0284-186X}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{212--218}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Oncologica}},
  title        = {{Palliative short-course hypofractionated radiotherapy followed by chemotherapy in esophageal adenocarcinoma : the phase II PALAESTRA trial}},
  url          = {{http://dx.doi.org/10.1080/0284186X.2019.1670861}},
  doi          = {{10.1080/0284186X.2019.1670861}},
  volume       = {{59}},
  year         = {{2020}},
}