[Treatment of locally advanced esophageal cancer by combined intralumenal brachytherapy and external beam radiotherapy].

The prognosis of patients with esophageal cancer is poor, due to frequent local recurrence and distant metastasis. The last decade has also seen that brachytherapy as a treatment with real potential to improve the therapeutic ratio of external irradiation. From March 1993 to October 1994 at the Institute of oncology and radiology in Belgrade, 18 patients with locally advanced esophageal cancer were treated by combined intralumenal brachytherapywith external beam irradiation. Median age was 59.6 years (range 43-70) and male/female ratio 2.6:1. Biopsy via endoscopy showed squamous cell carcinoma in 17 patients and adenocarcinoma in one case. External beam radiotherapywas applied on linear accelerator by locoregional texhnique with tumor dose of 30-60 Gy in 10-30 fractions. Intralumenal brachytherapy was eprformed on microselectron with tumor dose 5-20 Gy in 1-4 fractions. Response rate (complete response rate + partial response rate) was registrated in 13/18 (72%) patients. The good paliative effect for dysphagia, continuated passage for any food and increase body weight was shown in 16/18 (88%) patients. Six months after treatment, 7/13 patients were free of disease. Acute complications as irradiation pesophagitis occured in majority of patients.