[Cancer of the cervical esophagus. 64 cases treated by radiotherapy. Evaluation and considerations]

Radiotherapy was applied in 64 of 88 cases of cervical esophagus cancer during the period 1968 to 1980. The lesions treated were 49 epitheliomas of the esophageal opening, excluding hypopharyngeal tumors extending into the esophagus, and 15 epitheliomas of the remaining cervical segment of the esophagus. Survival did not exceed 2 years in any patient, and the reasons for these poor results are investigated. These included the particular selection of patients, the choice of radiotherapy as basic treatment, and the dosage administered. A new therapeutic approach is proposed based on pathologic findings and the various therapeutic measures available. Preoperative chemotherapy is followed by a total laryngopharyngectomy, with a total esophagectomy without opening the thorax and under certain well defined conditions. Continuity is re-established by a gastropharyngostomy, and postoperative radiotherapy is given routinely. This very heavy therapeutic approach, is appropriate for selected patients only, other cases having, unfortunately, to make do with an association of radio and chemotherapy.