Intraluminal brachytherapy using a balloon applicator for superficial esophageal carcinoma: importance of applicator...

Intraluminal brachytherapy using a balloon applicator has been the treatment of choice for superficial esophageal carcinomas. During treatment, the applicator is made to expand to be cylindrical as determined from an AP radiograph. However, optimal expansion of the applicator is not usually confirmed by computed tomography (CT). Therefore, this study was conducted to assess the shape of the balloon applicator by CT. Ten patients with superficial esophageal carcinoma were treated with intraluminal brachytherapy using a balloon applicator. The applicators were expanded properly in all patients as viewed from the AP radiograph. In seven of 10 patients, optimal expansion of the applicator was observed on CT. However, in the remaining three patients, applicators were found to be distorted presumably not only by primary tumor and mediastinal lymph nodes but also by neighboring organs. These results indicate that, when treating superficial esophageal carcinoma using a balloon applicator, there may be risks of applicator distortion in some cases. Assessment by CT should be done to precisely confirm the shape of the applicator.