[The percutaneous-endocavitary irradiation of esophageal carcinomas]

In a prospective, nonrandomized study 43 patients with inoperable oesophageal carcinoma were treated with a combined therapy of external and intracavitary irradiation according to the Heidelberg protocol adjusted to tumor stage, general condition and age. The proportion of external beam to afterloading doses was 2/3:1/3. The reference doses were between 50 and 75 Gy. Intracavitary radiotherapy was carried out with a HDR-afterloading device in single doses of 5 Gy. In a median follow-up of 23 months 46% had a complete remission and 42% had a partial remission. Within ten months 17 patients (39.5%) showed local tumor progression or recurrence. Presently the estimated median survival time of the whole collective is eleven months. The median survival was significantly influenced by achievement of complete remission (17.7 months in comparison to 8.7 months by missing complete remission). After completion of therapy 90% had sufficient oral nutrition. During long-term follow-up in 44% of the cases repeated measures had to be taken to eliminate initial or recurrent dysphagia. Almost all postradiogenic stenoses were caused by tumor progression. Radiogenic side-effects caused by HDR-afterloading boosts, exceeding the acceptance, were not found. The combined therapy reduces the period of hospitalisation and has the same palliative effects as an exclusively external radiotherapy.