Intraluminal brachytherapy in oesophageal cancer: a simple afterloading technique

Carcinoma of the oesophagus occurs in a good number of patients in any oncology department. Management is either by surgery or radiotherapy. In view of the proximity of the oesophagus to the critical organs in the thorax, effective external beam radiotherapy becomes difficult. A possible solution could be the use of intraluminal brachytherapy (ILB) in addition to external radiotherapy. In this paper a simple and locally developed method of ILB is described which delivers an effective boost to the oesophageal lesion in radical treatments and gives good palliation in advanced cases. Also, this system takes the load off the low dose rate afterloading machines used for intracavitary therapy in gynaecological cancers which otherwise would have also been used for the ILB treatment of oesophageal cancers. A description of the manual afterloading ILB applicator, the technique of its application, and a review of literature, is presented.