Combined external beam and intracavitary radiotherapy in oesophageal carcinoma

Seventy patients (40 males, 30 female; age 36-87 years, median 72 years) who were unsuitable for surgery were referred to the Regional Radiotherapy Centre, Newcastle General Hospital with oesophageal carcinoma (54 squamous cell; tumour length 2-14 cm). Sixty-seven patients received combined external beam radiotherapy (20-50 Gy in 5-20 fractions over 1-4 weeks) followed by intracavitary radiation (66 patients received 10 Gy at 1 cm; the remaining 4 received less) using an endoscopically inserted afterloading technique at 6.4 Gy/hour. Swallowing was restored in 65 patients (92%), although 39 patients (55.7%) subsequently required dilatation. Four developed fistulae (1 day, 2 months, 11 months, 17 months post-treatment). The actuarial survival was 71% at 6 months and 42% at 1 year. The combined treatment is well tolerated, with few complications and provides good palliation.