Small, superficial esophageal carcinoma treated with high-dose-rate intracavitary irradiation only.

Abstract

Six patients with small, superficial carcinoma of the esophagus were treated with 18-24 Gy of high-dose-rate intracavitary irradiation only. All patients were examined with an endoscope within 1 month after therapy, and the tumor in all six had disappeared. However, erosion induced by high-dose-rate intracavitary irradiation was seen in five of the patients. Five of the patients have experienced no local recurrence; endoscopic biopsy showed local recurrence in the remaining patient 7 months after radiation therapy. All patients have survived 6-16 months. Esophageal ulceration induced by intracavitary irradiation occurred in three of the six patients; however, the ulcers have been healing with conservative treatment. This new method of using only high-dose-rate intracavitary irradiation appears to be effective in the patient with small, superficial esophageal carcinoma.

Radiation therapy alone for stage I (UICC T1N0M0) squamous cell carcinoma of the esophagus: Indications for surgery or combined chemoradiotherapy

“…Furthermore, the beneficial effects of IBT after RT on the prognosis still remain unknown. [9][10][11][12][13][14][15][16] In regard to previous reports on the effects of IBT for T1, N0 tumor, Okawa et al . 9 showed that the LRC in patients treated with EBRT plus IBT was more favorable than that in the group receiving EBRT alone.…”

“…19,20 Therefore, it is possible that CRT can yield improved tumor control in highrisk patients with SMEC. However, it has been reported that RT alone is a very effective treatment for T1, N0 tumor [9][10][11][12][13][14][15][16] and, in Japan, there will be a great demand for the treatment without an additive chemotherapy because the number of patients of advanced age has been rapidly increasing. In fact, 35% of patients in this study were 75 years old or over, and this trend is to be further expected in an aging society of Japan.…”

“…Another problem related to RT is that the benefit of intraluminal brachytherapy (IBT) on the local control or survival in patients with T1, N0 tumor still remains controversial. [9][10][11][12][13]15,16 Endoscopic mucosal resection (EMR) and surgical resection have also been reported to be potentially curative treatment methods for T1, N0 tumor. [3][4][5][6]17,18 Furthermore, combined chemoradiotherapy (CRT) has been shown to yield an excellent treatment outcome in not only early, but also advanced esophageal cancer.…”

External beam radiation therapy with or without high-dose-rate intraluminal brachytherapy for patients with superficial esophageal carcinoma

“…This high complication rate apparently is related to the high fraction size of HDR-IBT. In fact, Hishikawa et al 13,14 used a fraction size of 6 Gy at 5 mm from the surface of a 10-mm applicator. Although we reduced the fraction size to 4 Gy in the current study, there were still two esophageal ulcers.…”

Braquiterapia endoluminal como tratamiento del carcinoma de esófago en estadio I

“…11,12 han publicado no sólo un aumento del control local para los pacientes tratados con braquiterapia sino también un aumento de la supervivencia.…”