[High-dose-rate brachytherapy. The indications, technic and preliminary results]

The authors report their experience of high dose brachytherapy technique (HDR), relative to the first period of work, especially regarding treatment indications and preliminary clinical results. Twenty eight patients were examined, 12 of them with esophageal carcinoma, 7 biliary tract carcinoma, 6 skin of the face and 3 head and neck carcinoma. HDR brachytherapy was the first treatment in 20 cases; the other 8 cases were recurrences after previous irradiation. The HDR treatment had a curative purpose in 15 patients and was palliative in the other 13. Brachytherapy doses ranged from 20 to 30 Gy for curative treatments, with 4-8 fractions; 1 fraction was used for palliative radiotherapy, with doses from 5 to 10 Gy. The results were satisfactory. Local control was achieved in 5/6 patients affected with cholangiocarcinoma of the biliary tract and in 6/6 patients with skin neoplasia. In esophageal cancer, 9/12 patients treated with palliative, disobstructive purpose, showed dysphagia remission in 89% of the cases; the remission was maintained in 7 patients (78%), with 9 months median follow-up. HDR brachytherapy was then proved, during this first period of clinical application, as a valid and safe therapeutic method. It also allowed to extend the application field of brachytherapy, with new indications, as in esophageal neoplasias and biliary tract carcinomas.