Brachytherapy in the Palliation of Oesophageal Cancer: Effective but Impractical?
Dysphagia in people with advanced oesophageal cancer can be treated by oesophageal stents, external beam radiotherapy (EBRT) and intraluminal brachytherapy. Despite guidelines recommending brachytherapy for patients with a predicted life expectancy exceeding 3 months, its uptake in the UK has been limited. Here we examine the strength of the evidence supporting the use of brachytherapy compared with oesophageal stents and EBRT and possible reasons for its limited uptake. Trials and observational studies suggest brachytherapy alone confers a benefit to patients, but its impact is less immediate than oesophageal stents; the evidence on effectiveness and value-for-money is limited. Moreover, stronger evidence will probably be insufficient to increase uptake, due to the extra complexity of delivery compared with stents and EBRT and a lack of experience among specialists.
['Sinha|S|S|', 'Varagunam|M|M|', 'Park|M H|MH|', 'Maynard|N D|ND|', 'Trudgill|N|N|', 'Crosby|T|T|', 'Cromwell|D A|DA|']
D000293:Adolescent D000328:Adult D000368:Aged D001918:Brachytherapy D003680:Deglutition Disorders D004938:Esophageal Neoplasms D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010166:Palliative Care D055815:Young Adult
Brachytherapy oesophageal cancer dysphagia palliative care