External beam radiotherapy and intraluminal brachytherapy in advanced inoperable esophageal cancer: JIPMER experience

From January 1994 to September 1998, all inoperable cases of cancer of the esophagus at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India were given external beam radiotherapy (EBRT) 36 Gy/18 times by anteroposterior pair. After EBRT, those patients who...

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Bibliographic Details
Published inAmerican journal of clinical oncology Vol. 24; no. 2; p. 128
Main Authors Vivekanandam, S, Reddy, K S, Velavan, K, Balasundaram, V, Ranga Rao, S, Subba Rao, K S, Nachiappan, M
Format Journal Article
LanguageEnglish
Published United States 01.04.2001
Subjects
Adult
Aged
Brachytherapy
Carcinoma, Squamous Cell - radiotherapy
Dilatation
Esophageal Neoplasms - radiotherapy
Esophagoscopy
Female
Humans
Male
Middle Aged
Palliative Care
Radiotherapy Dosage
Survival Analysis
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Summary:From January 1994 to September 1998, all inoperable cases of cancer of the esophagus at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India were given external beam radiotherapy (EBRT) 36 Gy/18 times by anteroposterior pair. After EBRT, those patients who could be intubated with 16 F Levine's tube either directly or after endoscopic dilatation were given intraluminal brachytherapy (ILBT) 36 Gy in 48 hours at 1 cm. Others were treated by EBRT by posterior oblique fields 24 Gy/12 times. Fifty-eight patients who received EBRT and ILBT formed the study group. Fifty percent had middle one third growth and except for three, all were squamous cell carcinoma (95%). Fifty-nine percent required postradiation endoscopic dilatation. The overall survival rate was 24% at the end of 1 year. In one patient, tracheoesophageal fistula developed 4 months after treatment. Mild-to-moderate acute esophagitis developed in 10% of the patients, and 2% had slight hemoptysis, but these were not significant enough to interrupt treatment. There was no treatment-related mortality. Thirty-four patients (59%) were followed up for 6 months to 5 years (mean, 9.6 months). Three patients had follow-up of more than 3 years with no evidence of disease. EBRT with ILBT, with intermittent esophageal dilatations as required, offers very good palliation in advanced inoperable cancer of the esophagus.
ISSN:0277-3732
1537-453X
DOI:10.1097/00000421-200104000-00005