High-dose-rate intraluminal brachytherapy for esophageal cancer: 10 years experience in Hyogo College of Medicine

Results of External Irradiation and Low-Dose-Rate Intraluminal Brachytherapy for Esophageal Cancer

“…Several papers have reported that late complications such as esophageal stricture or perforation occurred in patients treated with high-dose-rate ILBT (HDR-ILBT) (12)(13)(14)(15). Hishikawa et al reported that 15 out of 148 patients (10%) had esophageal stricture and 6 patients (4%) had esophageal stulas after 60 Gy ERT and 12 Gy:2 fractions at 5 mm beyond the surface of the esophagus of HDR-ILBT (12).…”

High dose rate brachytherapy before external beam irradiation in inoperable oesophageal cancer

“…Intraluminal radiotherapy (brachytherapy) is not new, but recent technical advances allowing HDR brachytherapy may offer several advantages over the conventional technique of external irradiation alone: better local control, reduction of treatment time and, when given before external radiotherapy, rapid improvement of dysphagia. Several studies (Hyden et al, 1988;Petrovich et al, 1991;Sur et al, 1992) (Flores et al, 1989;Hishikawa et al, 1991).…”

“…Although local response was excellent and sideeffects acceptable, eventually patients suffered from local recurrent disease, which was rapidly fatal in 59%. Thus, there is still a major need for improvement of long-term results, which might be achieved by a higher dose of external radiotherapy, as used by Hishikawa et al (1991), or by combining radiotherapy with multiagent full dose chemotherapy. A review of studies (Rich and Ajaui, 1994) reporting the results of combined modality, showed a modest benefit compared with radiotherapy alone, e.g.…”

“…Since the review of the literature on the role of radiotherapy by Earlam and Cunho-Melo (1980), radiation techniques have changed, especially after brachytherapy was in favour again when remote control techniques became available, as described by Rowland and Pagliero (1985); followed by others (Petrovich et al, 1991;Smalley et al, 1994). In most studies (Caspers et al, 1993;Flores et al, 1989;Gaspar, 1994;Hishikawa et al, 1991;Hyden et al, 1988;Sur et al, 1992), intracavitary irradiation has been used as a booster following external radiotherapy, which has the advantage of delivering a high dose to a small tumour volume.…”

Radiation Therapy for Esophageal Cancer

“…For instance, it was reported in the long-term experience with esophageal brachytherapy treatment [36] that radiation was delivered at a level of 5 mm below the surface of the mucosa. However, no correlation was found between the post-treatment complications and the diameter of the brachytherapy applicator [37]. In most of the HDR brachytherapy treatments, 3D treatment plans were generated using computed tomography (CT) images; however, magnetic resonance imaging (MRI) can be used to assist the localization of the tumor and the applicator [38].…”