Radical External Beam Radiotherapy With Intraluminal High Rate Dose Brachytherapy In Patients With Carcinoma Esophagus

Abstract

Aims: -Oesophageal carcinoma is an uncommon malignancy, accounting for approximately 1% of all malignancy and 6% of all gastrointestinal malignancies, patients with carcinoma oesophagus usually present with advanced disease. A combination of external and intraluminal radiation therapy is useful to palliate these patients. We report the findings of a retrospective study done on patients with carcinoma oesophagus who were treated withExternal radiationtherapy Followed by Intraluminal brachytherapy.Methods-21 patients who received ILBT followed by EBRT in year 2006-7, of unresectable carcinoma oesophagus without any history of previous anticancer treatment were given external radiotherapy, 40 Gy in 20 fractions over 4 weeks. After gap of two to three week all patients were given Intraluminal high dose rate brachytherapy (5 cGy /3fr/one week apart) were enrolled for this retrospective study. After completion of treatment patients were evaluated every moths for clinical response, toxicity and survival. Results-Majority of patients were ranged 48-66, with median age of presentation was 57 years. 20 (95%) were male and 1(5%) was female patient. Dysphagia free survival was seen in 20 (95%) of patients. Recurrence was seen in one (5%) patient after completion of four months of follow up. Complete response seen in 19 patients (90.4%) at the completion of treatment. Two patients (9.52%) showed persistent disease. Conclusions-The use of HDR-ILBRT, as a treatment for unresectable oesophageal cancer, was significantly effective and HDR-ILBRT contributed to improve outcomes, as well as symptoms free survival in patients with advanced oesophageal cancer. Oesophageal stricture is a common late toxicity in IBT for oesophageal carcinoma. Late complications, including oesophageal ulcer and fistula, were not seen in the present study.