[Combination external and internal radiotherapy for esophageal carcinoma: a new prospect]

Thirty-five patients with an inoperable or non-resectable oesophageal carcinoma were treated with external radiotherapy to a maximum dose of 60 Gy followed by a booster irradiation by means of intraluminal brachytherapy at a low dose rate (40-112 cGy/h). For this extra irradiation, which lasted 20-36 h, a catheter with a thickness of 3 mm was introduced through the nose. This treatment could be carried out without sedation. The total radiation dose after the combination therapy amounted to 65-75 Gy. Of the 35 patients, 17 were pretreated with dilatation or laser therapy. The palliative effect after the external and internal irradiation was very good; only one patient still had minor dysphagia 6 weeks after the treatment. Transient irradiation oesophagitis occurred in 16 patients. In three patients, a secondary benign stenosis developed. The median duration of survival was 11 months, the 2-year survival rate was 10%. A comparison of these results with a historical control group treated only with external irradiation shows that the duration of survival of these patients appears to be increased during the first 45 weeks.