Clinical study of the HDR brachytherapy and external radiotherapy for esophageal cancer

Objective To evaluate the clinical application of external radiotherapy ccombined with high-dose-rate(HDR) intraluminal brachytherapy for esophageal cancer Method From June 1991 to October 1993, 215 cases of esophageal cancer were randomly allocated into two groups. 130 cases(the tretment group)were received 58～60 Gy of external radiation plus 15 Gy - 16 Gy of brachytherapy in two or three fraction at a point 1 cm form the source. 85 cases(the control) were received 68～70Gy of external radiation only. The field length of high-dose-rate intr- raluminal brachytherapy was 1 cm above and below the superior and inferior margins of the tumor. Result The l, 3and 5 year survival rates in the patients of control group were 41. 18%, 25. 88%, 12. 94% respectively, and the treatment group were 62. 31%, 35. 38% and 19. 23% respectively. The significant difference was observed between two groups in 1 year survival rates. No significant difference was observed in 3 and 5 year suvival rate. The significant difference was observed in l, 3 year survival rate in treatment group with breast and bank pain at diagnosis. Esophagitis were more when single dose was more than 8Gy than 5Gy, the significant different was observed. Conclusion From our experience HDRIBT boost after ERT is proven to be safe and effective for patient with esophageal cancer The 1 year survival rate treated with HDRIBT and ERT is better than the ERT alone. No significant difference was observed in 3 or 5 year survival rate. Esophagitis were more (57. 69% )when tretment with HDRIBT and ERT. Esophageal complication were the one of reasons effective survival rate after treated in esophageal cancer.