A PROSPECTIVE AND COMPARATIVE STUDY ON CONCURRENT RADIOTHERAPY WITH GEFITINIB VERSUS RADIOTHERAPY ALONE IN THE TREATMENT OF ELDERLY PATIENTS WITH CARCINOMA OESOPHAGUS
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i7.44912Keywords:
Carcinoma Esophagus, Gefitinib, Radiotherapy, Elderly patientsAbstract
Objective: Concurrent chemoradiotherapy (CTRT) is the primary treatment for inoperable carcinoma esophagus. However, elderly patients are often not capable of tolerating CTRT, leaving radiotherapy as only option available for them. Many studies showed efficacy of anti-EGFR agent Gefitinib with acceptable toxicity profile in carcinoma esophagus patients. Hence, in this study, we compared radiation along with Gefitinib against radiation alone for the treatment of inoperable esophageal carcinoma in elderly patients in terms of locoregional control and toxicity profile.
Methods: Patients of 50–70 years age group with inoperable squamous cell carcinoma esophagus were randomized in two groups – the control group received external beam radiotherapy 50.4 Gy in two phases over 5 weeks and the study group received radiotherapy with same dose along with Tab Gefitinib-250 mg daily during the radiotherapy. Response assessment was done after completion of treatment and all patients were followed up weekly during the course of treatment and then at every month for at least 6 months.
Results: Overall response rate (complete+partial response) was better in study arm (80% vs. 70%), but not statistically significant (p=0.221). Just after treatment completion dysphagia of grade2 and above was more in control arm but after 3 months there was rise in incidences of dysphagia in study arm (66.6% vs. 60% p=0.632). Although statistically not significant, gefitinib containing study arm showed more incidences of higher grade of diarrhoea (20% vs. 15%, p=0.843) and moderate to severe grade of anaemia (90% vs. 66%, p=0.921).
Conclusion: We can say that concomitant treatment with Gefitinib and radiotherapy was well tolerated and effective in elderly patients of inoperable carcinoma esophagus.
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