External beam radiation therapy with or without high-dose-rate intraluminal brachytherapy for patients with superficial esophageal carcinoma

Abstract

Clinical results of external beam radiation therapy (RT) with or without intraluminal brachytherapy (IBT) for patients with superficial esophageal carcinoma were evaluated retrospectively. Between 1985 and 1996, 21 patients with superficial esophageal squamous cell carcinoma were treated by external beam RT, with or without high dose rate IBT, with curative intent. There were 18 males and 3 females; their median age was 67 years (range, 51-85 years). Eight patients were treated by external beam RT alone (60-69 gray [Gy]), whereas the remaining 13 patients were treated by IBT after external beam RT. Most patients in the IBT group received 2 or 3 fractions of IBT of 4 Gy after external beam RT of 50-56 Gy. All of the 21 tumors showed complete regression at the end of RT. Local recurrence was noted in 4 patients in the group that received external beam RT alone and in 2 patients in the IBT group. Salvage therapy was successful for 4 patients. Local control probability and cause specific survival probability for the IBT group were significantly higher than those for the group that received external beam RT alone (P < 0.05 for both). The 3-year local control and cause specific survival rates for the IBT group were 85% and 100%, respectively, whereas those for the external beam RT group were 45% and 67%, respectively. Transient esophageal ulcers were noted in two patients in the IBT group. External beam RT and IBT is a safe and effective treatment modality for patients with superficial esophageal carcinoma.