The radiochemotherapy of the oesophageal cancer

Abstract

To prove the efficacy of the simultaneous radio-chemotherapy of the inoperable or non-resectable esophageal cancer. Twenty-nine patients with inoperable or non-resectable oesophageal cancer were treated between January 1995 and December 2002. The therapy was started with intraluminal HDR AL irradiation for the recanalisation of the esophagus (8 Gy at 0.5 cm depth, repeated two-three times, with one-week interval), followed by percutaneous megavolt irradiation one week after the last HDR AL session (50 Gy total dose, 5 x 2 Gy/week fractions for 5 weeks). The chemotherapy was started simultaneously with the percutaneous megavolt irradiation (three courses of Cisplatin-5-Fluorouracil combination, with four-week intervals). The swallow function has been improved in 16/29 patients, it remained unchanged in 10/29 and got worse in 3/29 patients (1 and 3 Units), respectively. REMISSION: complete 9/29 patients, partial 17/29 patients. Side effects: Esophagitis of different degree occurred in all patients, consecutive transitory dysphagia developed in 8/29 patients, leucopenia after the chemotherapy in 2/29 patients, tracheo-esophageal fistula in 3/29 patients. Follow-up time: average 12.2 months (3-55 months). The duration of the swallow function improvement: average 10.7 months (2-55 months). The initial results refer to the favourable effect of the palliative radio-chemotherapy of the inoperable esophageal cancer.