[External irradiation combined with intracavitary brachytherapy for esophageal cancer]

To study the long-term treatment results and acute irradiation response as well as complications following external irradiation combined with intracavitary brachytherapy.

After loading intracavitary brachytherapy was used for patients with esophageal cancer. In 92 patients with esophageal cancer, 47 (group A) were treated with external irradiation only, and 45 (group B) with external irradiation and brachytherapy. The doses were 60.0 Gy - 70.0 Gy per 6-7 week for external irradiation, using 8 or 10 MV liner accelerator, and 5.0-8.0 Gy per fraction for intracavitary therapy.

There was a significant difference in acute response and complications as well as local recurrence rate between the two groups (P < 0.05). The survival rates of groups A and B at 1,3 and 5 years were 59.6%, 25.6%, 10.6% and 80.0%, 46.7%, 26.7% respectively (P < 0.05 respectively, using chi2 test). The complications related to intracavitary irradiation were esophageal perforation, esophagorrhagia, esophagotracheal fistula and esophageal narrowing. 66 patients died and 9 lost follow-up, giving a follow up rate of 90.2%.

External irradiation combined with afterloading intracavitary brachytherapy for esophageal cancer can reduce the local recurrence and enhance the long-term survival but with an increase of complications compared with the patients treated with external irradiation alone.